This version of the form is not currently in use and is provided for reference only. Download this version of Form 1430 for the current year.
This is a legal form that was released by the New York State Department of Health - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is a Health Care Proxy?
A: A Health Care Proxy is a legal document that allows you to appoint someone to make medical decisions on your behalf if you are unable to do so.
Q: Who can create a Health Care Proxy?
A: Any person who is 18 years of age or older and is capable of making their own medical decisions can create a Health Care Proxy.
Q: How do I complete Form 1430?
A: You need to fill in your personal information, choose your agent, and sign the form in the presence of two adult witnesses.
Q: Can I revoke my Health Care Proxy?
A: Yes, you can revoke your Health Care Proxy at any time as long as you are mentally competent.
Q: Can my agent override my wishes?
A: No, your agent can only make decisions that are consistent with your wishes or your best interests, if your wishes are not known.
Q: When does a Health Care Proxy go into effect?
A: A Health Care Proxy goes into effect when your primary physician determines that you lack the capacity to make your own medical decisions.
Q: Can my agent refuse treatment for me?
A: No, your agent cannot refuse treatment for you. They can only make medical decisions on your behalf.
Q: Is a Health Care Proxy legally binding?
A: Yes, a Health Care Proxy is legally binding as long as it is properly completed and signed in the presence of two adult witnesses.
Q: Can I have multiple Health Care Proxies?
A: No, you can only have one Health Care Proxy at a time. If you create a new one, it will automatically revoke any previous proxies.
Form Details:
Download a fillable version of Form 1430 by clicking the link below or browse more documents and templates provided by the New York State Department of Health.