NEW MEXICO HEALTH CARE POWER OF ATTORNEY

(Durable Medical Power of Attorney & Advance Directive with HIPAA Authorization)

[// GUIDANCE: This template is intentionally comprehensive and drafted for attorney customization. Review all bracketed placeholders and elective provisions for suitability before client execution.]

TABLE OF CONTENTS

I. Document Header
II. Definitions
III. Operative Provisions
IV. Representations & Warranties
V. Covenants & Restrictions
VI. Default & Remedies
VII. Risk Allocation
VIII. Dispute Resolution
IX. General Provisions
X. Execution Block

I. DOCUMENT HEADER

1. Title.
   HEALTH CARE POWER OF ATTORNEY AND ADVANCE DIRECTIVE (New Mexico)

2. Parties.
   a. Principal: [FULL LEGAL NAME], residing at [ADDRESS] (“Principal”).
   b. Agent: [FULL LEGAL NAME], residing at [ADDRESS] (“Agent”).

3. Effective Date.
   This instrument is effective as of [DATE] (the “Effective Date”).

4. Governing Law.
   This instrument is governed by and construed in accordance with the New Mexico Uniform Health-Care Decisions Act, NMSA 1978, § 24-7A-1 et seq., and other applicable federal and state health-care laws (collectively, “State Health-Care Law”).

5. Recitals.
   WHEREAS, Principal desires to appoint a health-care decision-maker pursuant to State Health-Care Law; and
   WHEREAS, Principal intends that this document constitute a durable power of attorney for health care, an advance health-care directive, and a HIPAA-compliant authorization;

NOW, THEREFORE, Principal executes this instrument on the terms set forth below.

II. DEFINITIONS

For purposes of this instrument, capitalized terms have the meanings set out below:

“Advance Directive” – The combination of instructions and powers granted herein regarding present or future health-care decisions.

“Agent” – The individual appointed in Section III.1, including any Successor Agent.

“End-of-Life Decision” – Any decision concerning the withholding, withdrawal, or continuation of life-sustaining treatment, artificially provided nutrition or hydration, resuscitative measures, or similar interventions.

“Good Faith” – Honesty in fact and the observance of reasonable health-care standards applicable to the Agent at the time of a decision.

“Health-Care Decision” – As defined in NMSA 1978, § 24-7A-1(F), including consent, refusal, or withdrawal of consent to care, service, or procedure.

“HIPAA” – The Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, 45 C.F.R. Parts 160 & 164.

“Principal” – The person executing this instrument and granting authority to Agent.

“Protected Health Information” or “PHI” – Individually identifiable health information as defined by HIPAA.

“State Probate Court” – The probate division with jurisdiction over this instrument pursuant to NMSA 1978, § 45-1-302.

III. OPERATIVE PROVISIONS

1. Appointment of Agent.
   Principal hereby appoints [AGENT NAME] as Agent to make any and all Health-Care Decisions on Principal’s behalf.

2. Successor Agent(s).
   a. 1st Successor: [NAME / “None”]
   b. 2nd Successor: [NAME / “None”]
   A Successor Agent shall serve only upon the written resignation, death, incapacity, ineligibility, or unwillingness of the immediately-prior Agent.

3. Scope of Authority.
   Subject to Section III.4 and applicable law, Agent may:
   i. Provide or withhold informed consent to medical treatment;
   ii. Select or discharge health-care providers or facilities;
   iii. Authorize admission to or discharge from any facility;
   iv. Access, release, or withhold PHI;
   v. Authorize autopsy, organ donation, and disposition of remains;
   vi. Execute all documents and take all actions reasonably necessary to implement these powers.

4. Limitations & Instructions.
   a. End-of-Life Provisions.
   i. Life-Sustaining Treatment: [“Withhold” / “Continue” / “Agent’s discretion”]
   ii. Artificial Nutrition/Hydration: [“Withhold” / “Continue” / “Agent’s discretion”]
   iii. Pain Relief: Provide any medication or intervention necessary for comfort, even if it may hasten death.
   b. Pregnancy. [OPTIONAL – include specific instructions consistent with NM law]
   c. Organ & Tissue Donation. [SPECIFY or “Agent’s discretion”]

5. Durability.
   This power of attorney is durable and shall not be affected by Principal’s subsequent incapacity.

6. Nomination of Guardian.
   If a court of competent jurisdiction deems a guardian necessary, Principal nominates the Agent as guardian of person and estate.

7. Revocation.
   Principal may revoke this instrument at any time by:
   i. A signed writing;
   ii. Personally informing the supervising health-care provider; or
   iii. Destroying the document with intent to revoke.
   Any divorce automatically revokes the appointment of a spouse as Agent unless expressly reaffirmed.

8. Conditions Precedent.
   Agent’s authority arises upon determination by the attending physician or qualified health-care professional that Principal is unable to make or communicate Health-Care Decisions, unless Principal elects immediate effectiveness here: [“Immediate” / “Upon incapacity”].

IV. REPRESENTATIONS & WARRANTIES

1. Principal’s Representations.
   a. Capacity. Principal is of sound mind and at least eighteen (18) years of age.
   b. Voluntariness. Execution is voluntary and free from coercion.

2. Agent’s Representations (to be acknowledged in Section X).
   a. Will act only in Good Faith and in compliance with this instrument and State Health-Care Law.
   b. Is not a disqualified individual under NMSA 1978, § 24-7A-2(C).

3. Survival. The representations and warranties survive execution and remain enforceable for the duration of the instrument.

V. COVENANTS & RESTRICTIONS

1. Agent’s Affirmative Covenants.
   a. Act consistently with Principal’s expressed wishes and, where unknown, Principal’s best interests.
   b. Consult available medical professionals and records before making material decisions.
   c. Maintain contemporaneous records of major Health-Care Decisions.

2. Negative Covenants.
   Agent shall not:
   a. Delegate authority except to a duly-appointed Successor Agent;
   b. Execute any Health-Care Decision primarily for financial gain;
   c. Override limitations expressly set forth in Section III.4.

3. Notice Obligations.
   Agent shall inform all relevant health-care providers of authority under this instrument and provide copies upon request.

4. Cure Period.
   If Agent breaches any covenant, a Successor Agent (or interested person under State Health-Care Law) may deliver written notice specifying the breach. The Agent has forty-eight (48) hours to cure before temporary suspension.

VI. DEFAULT & REMEDIES

1. Events of Default.
   a. Agent’s failure to act in Good Faith;
   b. Breach of any covenant or limitation;
   c. Legal disqualification or incapacity of Agent.

2. Remedies.
   a. Automatic elevation of Successor Agent;
   b. Petition to State Probate Court for injunctive relief or Agent removal;
   c. Recovery of damages proximately caused by bad-faith conduct, including reasonable attorney fees and costs.

3. Attorney Fees.
   A prevailing party in any action to enforce this instrument is entitled to reasonable attorney fees and court costs.

VII. RISK ALLOCATION

1. Indemnification.
   Principal shall indemnify and hold harmless Agent from any liability, expense, or claim arising from Good Faith actions under this instrument (“Good-Faith Standard”).

2. Limitation of Liability.
   Except for willful misconduct or gross negligence, Agent’s liability is limited to the extent of PHI or property directly in Agent’s control at the time of the wrongful act.

3. Insurance.
   [OPTIONAL] Agent shall be covered under any existing errors and omissions or fiduciary liability policy held by Principal, if available.

4. Force Majeure.
   Neither Principal nor Agent shall be liable for failure to perform any act required by this instrument if performance is prevented by circumstances outside reasonable control (including natural disaster, war, pandemic, or change in law) that materially impede performance.

VIII. DISPUTE RESOLUTION

1. Governing Law.
   This instrument is governed by State Health-Care Law and federal health-care regulations.

2. Forum Selection.
   Exclusive jurisdiction and venue reside in the State Probate Court for [COUNTY], New Mexico.

3. Arbitration & Jury Trial.
   Arbitration and jury waiver are not available under the metadata; parties retain applicable judicial remedies.

4. Injunctive Relief.
   Nothing herein limits any party’s right to seek emergency or injunctive relief to enforce the health-care directives contained herein.

IX. GENERAL PROVISIONS

1. Amendment & Waiver.
   Amendments must: (a) be in writing; (b) expressly reference this instrument; and (c) be executed with the same formalities as this document. No waiver is effective unless in writing and signed by the waiving party.

2. Assignment & Delegation.
   Assignments are prohibited except as expressly provided for Successor Agents.

3. Successors & Assigns.
   This instrument binds and benefits Principal, Agent, and their respective heirs, legal representatives, and permitted assigns.

4. Severability.
   If any provision is held unenforceable, the remaining provisions shall be reformed to the minimum extent necessary to effectuate the original intent.

5. Integration.
   This instrument constitutes the entire agreement relating to Principal’s Health-Care Decisions and supersedes all prior directives on the same subject matter, except to the extent expressly incorporated herein.

6. Counterparts & Electronic Signatures.
   This instrument may be executed in counterparts, each of which is deemed an original. Signatures transmitted via facsimile, PDF, or secure electronic signature platform are binding.

X. EXECUTION BLOCK

[// GUIDANCE: Select ONE of the two formalities options below (Notary OR Two Witnesses) as required by NMSA 1978, § 24-7A-5.]

A. Principal’s Signature

I, the undersigned Principal, sign my name to this Health Care Power of Attorney & Advance Directive on the Effective Date set forth above.

____ ___
[PRINCIPAL NAME] Date

B-1. Notarization (Choose this OR Witnesses)

State of New Mexico )
County of ____ ) ss.

Acknowledged before me on _ (date) by ______ (Principal).

Notary Public
My Commission Expires: ____

B-2. Witness Attestation (Choose this OR Notary)

We declare that the Principal is personally known to us, appears to be of sound mind, and under no duress, fraud, or undue influence. We are each at least eighteen (18) years of age and are not (i) the Agent, (ii) related by blood, marriage, or adoption, (iii) entitled to any portion of the Principal’s estate, or (iv) directly involved in Principal’s health-care.

Witness 1: _____ Date: __
Address: _______

Witness 2: _____ Date: __
Address: _______

C. Agent Acknowledgment

I, the undersigned Agent, accept the appointment under this Health Care Power of Attorney, and acknowledge my fiduciary duties and obligations.

____ ___
[AGENT NAME] Date

D. Successor Agent Acknowledgment(s) [OPTIONAL]

____ ___
[1ST SUCCESSOR NAME] Date

____ ___
[2ND SUCCESSOR NAME] Date

[// GUIDANCE: Attach any supplemental instructions, organ donation forms, or PHI release forms as schedules if desired.]