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Wills, estates & power of attorney
Designate a trusted individual to make personal care decisions on your behalf under Ontario's Substitute Decisions Act, 1992. This legally binding document takes effect if you become mentally incapable of managing your own care.
Also known as
POWER OF ATTORNEY FOR PERSONAL CARE
THIS POWER OF ATTORNEY FOR PERSONAL CARE is made by ______, residing in the City of ______, in the Province of ______.
REVOCATION
I. All previous Powers of Attorney for Personal Care or any earlier power of attorney affecting my personal care that I have granted are hereby revoked. I reserve the right to create additional Powers of Attorney for Personal Care in the future.
APPOINTMENT
II. I HEREBY APPOINT:
Name of the Attorney: ______
Attorney Address: ______
as my attorney for personal care under the Substitute Decisions Act, 1992 and I grant my attorney for personal care the authority to make decisions regarding my personal care, encompassing health care, nutrition, shelter, clothing, hygiene, and safety, in accordance with the Substitute Decisions Act and subject to any conditions, restrictions, specific directions, or special provisions set out in this document.
I wish my attorney(s) to hold authority to act: ______
SUBSTITUTE APPOINTMENT
III. If my attorney is unable or unwilling to serve due to death, removal by court order, incapacity, or resignation, or is unavailable when a decision regarding my personal care or treatment governed by the Health Care Consent Act is required, I SUBSTITUTE AND APPOINT:
Substitute Attorney Name: ______
Substitute Attorney Address: ______
to serve as my attorney for personal care, replacing and holding all powers granted to the attorney named in paragraph (II) above. The term 'my attorney' as used throughout this document shall, where the context allows, refer to whichever one or more persons are appropriate given the appointments made in paragraphs II and III above.
CONDITIONS AND RESTRICTIONS
IV. I acknowledge that death is inevitable. If, as my life draws to a close, I can no longer make decisions about my future, can no longer communicate, am unable to care for myself, have no reasonable prospect of recovering from severe physical or mental disability or incapacity, find myself in circumstances that prevent rational existence, or am suffering from an irreversible injury, disease, illness, or condition, then I direct my attorney to honour the following wishes:
(a) Where artificial life-sustaining measures would serve only to delay the moment of my death, let this document express my considered thoughts, intentions, wishes, and directions - that I ______. I sign this document freely and voluntarily, while of sound mind and emotionally capable of making such decisions.
(b) I believe in the principle of dying with dignity. Should any of the circumstances described in the preceding paragraphs arise, I direct that I be ______.
(c) The following are my specific requests:
(i) I request that ______.
(ii) If it will not cause undue hardship to my family, I wish to die at ______ rather than in an institution.
(iii) Should I be under the care of a physician whose moral, ethical, or religious convictions conflict with the wishes expressed in this document, I direct my attorney to request that physician to withdraw from my care and to recommend another physician who will respect my views on the prolongation of life. My attorney is also empowered to arrange my transfer to another hospital if necessary to carry out the directions in this document.
(iv) I hereby authorize and direct my attorney to pay from my assets any and all costs and expenses, including legal fees and court costs, that they consider necessary to ensure my directions as stated herein are carried out.
(v) No person involved in the creation or execution of this Power of Attorney for Personal Care, whether a health care provider, hospital administrator, spouse, relative, friend, or any other individual, shall be held liable in any way, legally, professionally, or morally, for any consequences resulting from the implementation of my wishes.
CONSENT TO TREATMENT
V. I authorize my attorney to give or withhold consent on my behalf to treatment governed by the Health Care Consent Act, 1996, applies.
ASSESSMENT OF CAPACITY
VI. If my capacity for personal care becomes an issue and a capacity assessment is needed, my physician at the time shall conduct the assessment; if that physician is unable or unwilling to do so, then any other physician or authorized capacity assessor chosen by my attorney shall perform such assessment.
COMPENSATION
VII. I declare that my attorney shall not be entitled to compensation from my assets for serving as my attorney and carrying out the duties and obligations required under this document. However, it is my wish that my assets be used to reimburse my attorney for any out-of-pocket expenses they incur in performing their duties and obligations hereunder.
SIGNED at the City of __________________, Province of __________________, this ____ day of __________ 20____, in the presence of the Witnesses named below. Neither witness is an attorney named in this document, a spouse or partner of the person granting this power of attorney, a child of the grantor or a person whom the grantor has shown a settled intention to treat as a child, nor a person whose property is under guardianship or who has a guardian of the person, nor a person under 18 years of age.
__________________________
Grantor: ______
__________________________ ___________________________
Name (1st Witness): Name (2nd Witness):
Address: Address
Occupation: Occupation:
Additional information
Optional Living Arrangements and Accommodation: ______
Additional Attorney (Optional): ______
Substitute Attorney Address: ______
Dispute Resolution Between Attorneys: ______
Address of Additional Attorney (Optional): ______
Persons to Consult: ______
Conditions on the Attorney (Optional): ______
How it works
Answer the questions on the left. Your document builds itself on the right as you type.
Get a clean, ready-to-sign PDF in seconds. No account, no watermark.
Book an appointment, bring your document, and we witness your signature and apply the seal.
A Power of Attorney for Personal Care is how Ontarians choose who will make decisions about their health, housing, food, hygiene, and safety if they ever become unable to make those decisions themselves. It is governed by the Substitute Decisions Act, 1992. It covers personal and medical matters only; a separate Continuing Power of Attorney for Property handles money and finances.
The person you name is your attorney for personal care. They step in only when you are found incapable of making a particular care decision, and they are expected to follow any wishes you expressed while you were capable. You can write specific directions into the document about living arrangements, treatments you would accept or refuse, and who should be consulted.
You must be at least 16 years old and mentally capable of understanding what you are granting at the time you sign. "Capable" means you understand the types of decisions the attorney could make and that the attorney may need to make those decisions for you.
The template captures everything needed to produce a valid Power of Attorney for Personal Care under Ontario law. Have the following information ready before your appointment.
The document must be signed in front of two witnesses, both of whom watch you sign and then sign the document themselves. Using the wrong witnesses is the most common reason these documents are later questioned, so verify eligibility before your signing appointment.
Ontario law requires two qualifying witnesses but does not require a notary. People still choose notarisation because hospitals, long-term care facilities, and institutions outside Ontario often want an independent record that the grantor signed freely and understood the document. Notarisation is particularly helpful when the attorney may need to use the document in another province or country.
We confirm your identity, witness your signature, and apply the notarial seal. The fee is $19.90 per stamp.
We are a notary office, not a law firm. We witness your signature but do not draft care directives or advise on medical choices. Consider consulting a lawyer if your wishes are complex, your family situation is contentious, or you want detailed instructions about specific medical treatments. A lawyer can also help you coordinate the personal care POA with a property POA and a will.
Frequently asked
Fill it in online, download a ready-to-sign PDF, then bring it in and we will notarize it, in person across Ottawa or online.