This form allows parents to appoint a caregiver to make healthcare decisions for their child in case they are unable to do so. It ensures that medical treatment can be provided promptly when needed.

Learn how interactive interviews work

Can I use this tool?

You can use this form if you are a parent or legal guardian and want to choose someone to make healthcare decisions for your child. It is important to ensure that the chosen person is trustworthy and understands your wishes regarding medical care.

How to select the right court form

Before you start

Before you get started

• Gather the necessary information about your child and the chosen caregiver.
• Include one or both parents who have legal custody of the child. Make sure all parents with legal custody agree with this choice.

When you are finished

• Sign the document in front of a notary public to make it legally binding.
• Provide a copy to the chosen caregiver and keep one for your records.

What happens after you finish

After completing this interview, you will get your completed forms ready for filing. This interview may give you more information about what happens next based on your answers. Learn how to file in Vermont.

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