Who can serve as an agent?

Any competent adult can serve as an agent unless state law disqualifies them; choose someone trustworthy who understands fiduciary duties. Institutions may require additional identity proof or decline an agent with a conflict of interest, so confirm acceptance beforehand.

Is notarization required?

Tennessee commonly requires notarization for POAs accepted by banks and for recording real estate. Remote notarization may be permitted under Tennessee notary rules; verify current RON statutes and recipient requirements before relying solely on electronic notarization.

Can I limit agent powers?

Yes. Use precise language to list permitted actions and expressly exclude categories you do not want the agent to manage. Include transaction thresholds, successor agents, and revocation methods to reduce interpretation disputes by third parties or courts.

How do I revoke a POA?

Revoke by executing a written revocation, notifying the agent and institutions that hold the POA, and retrieving or destroying originals where possible. File or record revocation if the POA was recorded and retain proof of notice to prevent continuing reliance.

Are electronic signatures valid?

Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted when the four e-sign validity elements are met: intent, consent, attribution, and retention. Confirm recipients accept eSigned and remotely notarized documents.

When should I consult an attorney?

Consult counsel for complex powers, large estate transfers, elder law concerns, contested capacity, or springing POAs. An attorney helps ensure statutory compliance with Tennessee law and minimizes the risk of later litigation or institutional refusal.

Electronic Signature
Templates
Tennessee Power of Attorney Form

Tennessee Power of Attorney Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

DURABLE POWER OF ATTORNEY
FOR HEALTH CARE

(Tennessee Code Annotated 34-6-203)

WARNING TO PERSON EXECUTING THIS DOCUMENT

This is an important legal Document. Before executing this document you should know these important facts.

This document gives the person you designate as your agent (the attorney in fact) the power to make health care decisions for you. Your agent must act consistently with your desires as stated in this document.

Except as you otherwise specify in this document, this document gives your agent the power to consent to your doctor not giving treatment or stopping treatment necessary to keep you alive. Notwithstanding this document, you have the right to make medical and other health care decisions for yourself so long as you can give informed consent with respect to the particular decision. In addition, no treatment may be given to you over your objection, and health care necessary to keep you alive may not be stopped or withheld if you object at the time.

This document gives your agent authority to consent, to refuse to consent, or to withdraw consent to any care, treatment, service, or procedure to maintain, diagnose or treat a physical or mental condition. This power is subject to any limitations that you include in this document. You may state in this document any types of treatment that you do not desire. In addition, a court can take away the power of your agent to make health care decisions for you if your agent: (1) authorizes anything that is illegal; or (2) acts contrary to your desires as stated in this document.

You have the right to revoke the authority of your agent by notifying your agent or your treating physician, hospital or other health care provider orally or in writing of the revocation.

Your agent has the right to examine your medical records and to consent to their disclosure unless you limit this right in this document.

Unless you otherwise specify in this document, this document gives your agent the power after you die to: (1) authorize an autopsy; (2) donate your body or parts thereof for transplant or therapeutic or educational or scientific purposes; and (3) direct the disposition of your remains.

If there is anything in this document that you do not understand, you should ask an attorney to explain it to you.

(1) DESIGNATION OF HEALTH CARE AGENT

I, do hereby designate and appoint:

None of the following may be designated as your agent: (1) your treating health care provider, (2) a nonrelative employee of your treating health care provider, (3) an operator of a community care facility, or (4) a nonrelative employee of an operator of a community care facility.) as my attorney in fact (agent) to make health care decisions for me as authorized in this document. For the purposes of this document, "health care decision" means consent, refusal of consent, or withdrawal of consent to any care, treatment, service, or procedure to maintain, diagnose, or treat an individual's physical or mental condition.

(2) CREATION OF DURABLE POWER OF ATTORNEY FOR HEALTH CARE

By this document I intend to create a durable power of attorney for health care. This power of attorney shall not be affected by my disability. I expressly reserve the right to revoke this power of attorney at any time.

(3) GENERAL STATEMENT OF AUTHORITY GRANTED

Subject to any limitations in this document, I hereby grant to my agent full power and authority to make health care decisions for me to the same extent that I could make such decisions for myself if I had the capacity to do so. In exercising this authority, my agent shall make health care decisions that are consistent with my desires as stated in this document or otherwise made known to my agent, including, but not limited to, my desires concerning obtaining or refusing or withdrawing life-prolonging care, treatment, services, and procedures.

INSPECTION AND DISCLOSURE OF INFORMATION RELATING TO MY PHYSICAL OR MENTAL HEALTH.

A. General Grant of Power and Authority. Subject to any limitations in this Directive, my agent has the power and authority to do all of the following: (1) Request, review and receive any information, verbal or written, regarding my physical or mental health including, but not limited to, medical and hospital records; (2) Execute on my behalf any releases or other documents that may be required in order to obtain this information; (3) Consent to the disclosure of this information; and (4) Consent to the donation of any of my organs for medical purposes.

B. HIPAA Release Authority. My agent shall be treated as I would be with respect to my rights regarding the use and disclosure of my individually identifiable health information or other medical records. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320d and 45 CFR 160 through 164. I authorize any physician, health care professional, dentist, health plan, hospital, clinic, laboratory, pharmacy, or other covered health care provider, any insurance company, and the Medical Information Bureau, Inc. or other health care clearinghouse that has provided treatment or services to me, or that has paid for or is seeking payment from me for such services, to give, disclose and release to my agent, without restriction, all of my individually identifiable health information and medical records regarding any past, present or future medical or mental health condition, including all information relating to the diagnosis of HIV/AIDS, sexually transmitted diseases, mental illness, and drug or alcohol abuse. The authority given my agent shall supersede any other agreement that I may have made with my health care providers to restrict access to or disclosure of my individually identifiable health information. The authority

given my agent has no expiration date and shall expire only in the event that I revoke the authority in writing and deliver it to my health care provider.

(If you want to limit the authority of your agent to make health care decisions for you, you can state the limitations in paragraph (4) ("Statement of Desires, Special Provisions, and Limitations") below. You can indicate your desires by including a statement of your desires in the same paragraph.)

(4) STATEMENT OF DESIRES, SPECIAL PROVISIONS, AND LIMITATIONS

(Your agent must make health care decisions that are consistent with your known desires. You can, but are not required to, state your desires in the space provided below. You should consider whether you want to include a statement of your desires concerning life-prolonging care, treatment, services, and procedures. You can also include a statement of your desires concerning other matters relating to your health care. You can also make your desires known to your agent by discussing your desires with your agent or by some other means. If there are any types of treatment that you do not want to be used, you should state them in the space below. If you want to limit in any other way the authority given your agent by this document, you should state the limits in the space below. If you do not state any limits, your agent will have broad powers to make health care decisions for you, except to the extent that there are limits provided by law.)

In exercising the authority under this durable power of attorney for health care, my agent shall act consistently with my desires as stated below and is subject to the special provisions and limitations stated below:

(a) Statement of desires concerning life-prolonging care, treatment, services, and procedures:

(b) Additional statement of desires, special provisions, and limitations regarding health care decisions:

(You may attach additional pages if you need more space to complete your statement. If you attach additional pages, you must date and sign EACH of the additional pages at the same time you date and sign this document.)

(5) INSPECTION AND DISCLOSURE OF INFORMATION RELATING TO MY PHYSICAL OR MENTAL HEALTH

Subject to any limitations in this document, my agent has the power and authority to do all of the following:

(a) Request, review, and receive any information, verbal or written, regarding my physical or mental health, including, but not limited to, medical and hospital records.
(b) Execute on my behalf any releases or other documents that may be required in order to obtain this information.
(c) Consent to the disclosure of this information.

(If you want to limit the authority of your agent to receive and disclose information relating to your health, you must state the limitations in paragraph (4) ("Statement of desires, special provisions, and limitations") above.)

(6) SIGNING DOCUMENTS, WAIVERS, AND RELEASES

Where necessary to implement the health care decisions that my agent is authorized by this document to make, my agent has the power and authority to execute on my behalf all of the following:

(a) Documents titled or purporting to be a "Refusal to Permit Treatment" and "Leaving Hospital Against Medical Advice."
(b) Any necessary waiver or release from liability required by a hospital or physician.

(7) DURATION

(Unless you specify a shorter period in the space below, this power of attorney will exist until it is revoked.)

This durable power of attorney for health care expires on

(Fill in this space ONLY if you want the authority of your agent to end on a specific date.)

(8) DESIGNATION OF ALTERNATE AGENTS

(You are not required to designate any alternate agents but you may do so. Any alternate agent you designate will be able to make the same health care decisions as the agent you designated in paragraph (1), above, in the event that agent is unable or ineligible to act as your agent. If the agent you designated is your spouse, he or she becomes ineligible to act as your agent if your marriage is dissolved.)

If the person designated as my agent in paragraph (1) is not available or becomes ineligible to act as my agent to make a health care decision for me or loses the mental capacity to make health care decisions for me, or if I revoke that person's appointment or authority to act as my agent to make health care decisions for me, then I designate and appoint the following persons to serve as my agent to make health care decisions for me as authorized in this document, such persons to serve in the order listed below:

(A) First Alternate Agent (Insert name, address, and telephone number of first alternate agent.):

(B) Second Alternate Agent (Insert name, address, and telephone number of second alternate agent.)

(9) PRIOR DESIGNATIONS REVOKED

I revoke any prior durable power of attorney for health care.

DATE AND SIGNATURE OF PRINCIPAL

(YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY)

I sign my name to this Durable Power of Attorney for Health Care on

Date:

City:

State:

Signature:

I declare under penalty of perjury under the laws of Tennessee that the person who signed this document is personally known to me to be the principal; that the principal signed this durable power of attorney in my presence; that the principal appears to be of sound mind and under no duress, fraud or undue influence; that I am not the person appointed as attorney in fact by this

document; that I am not a health care provider, an employee of a health care provider, the operator of a health care institution nor an employee of an operator of a health care institution; that I am not related to the principal by blood, marriage, or adoption; that, to the best of my knowledge, I do not, at the present time, have a claim against any portion of the estate of the principal upon the principal's death; and that, to the best of my knowledge, I am not entitled to any part of the estate of the principal upon the death of the principal under a will or codicil thereto now existing, or by operation of law.

Witness:

Address:

Witness:

Address:

STATE OF TENNESSEE

COUNTY OF

Subscribed, sworn to and acknowledged before me by the declarant, and subscribed and sworn to before me by and witnesses, this day of , 20

Notary Public

My Commission Expires:

What the Tennessee Power of Attorney Form Is

The Tennessee Power of Attorney Form is a legal document that lets a principal appoint an agent (attorney-in-fact) to act on their behalf for financial, property, health, or personal matters. The form defines the scope of authority, effective date, duration, and any limits or successor agents. Tennessee recognizes durable, springing, and limited powers of attorney; proper execution, notarization, and witness procedures affect acceptance by banks, recorders, and healthcare providers. Clear language reduces the risk of institutional refusal or later probate disputes.

Why a Proper Tennessee Power of Attorney Form Matters

The Tennessee Power of Attorney Form creates a legal delegation that avoids delays in managing finances, real estate, and healthcare decisions, clarifies authority limits, and helps prevent court-appointed guardianship when incapacity occurs.

Who Typically Uses a Tennessee Power of Attorney Form

Individuals and organizations use this form to delegate decision-making authority under Tennessee law.

Individual principals delegating financial authority to a trusted agent for bill payment, investments, or tax matters.
Elderly or incapacitated persons naming durable agents to manage property, healthcare proxies, and long-term care decisions.
Businesses or small-business owners authorizing representatives to sign contracts, close transactions, or handle banking.

Core parts of a professional Tennessee Power of Attorney Form

A complete form specifies the parties, enumerates agent powers, establishes effective and termination dates, includes durable language if needed, provides notarization and witness blocks, and records any special limitations or successor designations.

Parties

Identify principal and agent by full legal names, addresses, and contact details; match names to government ID such as driver's license or passport to avoid verification issues.

Agent Powers

List specific authorities granted—banking, real estate, tax filings, litigation—using precise language to avoid unintended breadth or institutional rejection.

Effective Date

State whether the POA is effective immediately, on a specified date, or upon incapacity; for springing POAs include objective incapacity criteria to reduce later disputes.

Durability Clause

Include explicit durable wording to ensure powers survive principal incapacity; absent such language, agency may terminate upon incapacity under common law.

Notarization

Provide a notarization block; many banks and county recorders require notarized POAs. Confirm whether remote online notarization is acceptable for the recipient.

Special Instructions

Add limits, successor agents, per‑transaction dollar thresholds, and a clear revocation procedure to reduce ambiguity and future litigation risk.

Step-by-step: complete and execute a Tennessee POA

Follow these steps to complete and execute a Tennessee Power of Attorney Form correctly and reduce acceptance delays.

01

Prepare documents: Gather IDs, existing POAs, and supporting documents.
02

Choose an agent: Confirm willingness and suitability; provide contact details.
03

Complete form: Fill every required field and initial where needed.
04

Sign and notarize: Sign before notary; secure required witnesses if state mandates.

How a Tennessee POA moves from draft to acceptance

This process overview shows how a POA moves from drafting to acceptance by institutions and ongoing recordkeeping.

Draft: Tailor powers and durations to your needs.
Execute: Sign, date, have notarized and witness if required.
Distribute: Provide certified copies to banks, attorneys, and healthcare providers.
Record/Store: Record real estate POA if required; retain originals securely.

Digital signing and notarization considerations

Use eSignature platforms that support notarization, audit trails, and secure storage to streamline POA execution when permitted by Tennessee law.

Signatures: Electronic signature capture allowed when ESIGN/UETA conditions met.
Notarization Support: Platform must support remote or in-person notarization workflows.
Authentication: Use multi-factor or ID verification for agent attribution.

Recommended eSignature workflow settings for a POA

Configure an electronic POA workflow to set signer order, authentication, notarization, and retention for Tennessee legal compliance.

Field	Configuration
Signer Order	Principal signs first \| Agent acknowledged after
Authentication	Email plus SMS or ID verification
Notary	Enable RON or schedule in-person session
Retention	Store signed PDF and audit trail securely

Penalties and risks of an incorrect or incomplete POA

Form Rejection: Banks may refuse agent actions

Financial Penalties: 1099 penalties $60–$330+ per form

Tax Withholding: Backup withholding 24% for missing TIN

Criminal Risk: Fraudulent use can lead to prosecution

Probate Costs: Improper POA can cause guardianship proceedings

HIPAA Violations: Unauthorized disclosures may incur HIPAA penalties

Common preparation pitfalls to avoid

Using imprecise or overly broad language that unintentionally grants unlimited authority, leading to disputes and third-party refusal to accept the POA.
Failing to notarize or obtain required witnesses before presenting the POA for real estate closing or bank acceptance, rendering the document unusable.
Neglecting to update or revoke the POA after major events such as divorce, remarriage, or agent incapacity, which can leave inappropriate persons empowered.
Submitting unsigned, unsigned-notarized, or uncertified copies when institutions demand originals, causing delays, additional requests, or rejection of transactions.

Timing and deadlines to consider when executing a POA

Key timing considerations affect when the POA takes effect, when it must be notarized, and how quickly institutions accept it.

Effective Date Choice:

Immediate, future, or upon incapacity. Specify clearly.

Notarization Timing:

Notarize at signing; RON may allow authorized remote notarization in permitted jurisdictions.

Distribution Timing:

Deliver certified copies to banks and providers promptly after execution.

Recording for Real Estate:

Record at county recorder when POA conveys or encumbers property.

Revocation Notice:

Notify institutions in writing when revoking; return originals.

eSignature vendor pricing and capability comparison

Side-by-side vendor pricing and capability summary for executing Tennessee Power of Attorney Forms; signNow appears first per comparison format.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes (Premium)	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes (BAA available)	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Practical scenarios showing POA use

Real-world examples show how Tennessee POAs are used across personal, healthcare, and business scenarios to simplify decision-making.

Estate planning

An elderly principal executes a durable Tennessee POA to authorize a trusted child to manage investments and pay recurring bills.

Gives immediate, durable authority upon signing.
Having a notarized, durable form on file with the principal's bank and broker prevented delays when the principal became incapacitated, allowing timely bill payments, investment adjustments, and avoidance of court guardianship procedures.

Real estate closing

A property owner uses a limited Tennessee POA to authorize a closing agent to sign deed documents while the owner is out of state.

Limited to a single real estate closing.
Providing the original notarized POA to the county recorder and lender allowed the transaction to close on schedule without the owner returning, reducing delay and additional travel expense.

Frequently asked questions about Tennessee POAs

Frequently asked questions about completing, notarizing, and revoking Tennessee Power of Attorney Forms with clear answers.

Need help? Contact support

Who can serve as an agent?
Any competent adult can serve as an agent unless state law disqualifies them; choose someone trustworthy who understands fiduciary duties. Institutions may require additional identity proof or decline an agent with a conflict of interest, so confirm acceptance beforehand.
Is notarization required?
Tennessee commonly requires notarization for POAs accepted by banks and for recording real estate. Remote notarization may be permitted under Tennessee notary rules; verify current RON statutes and recipient requirements before relying solely on electronic notarization.
Can I limit agent powers?
Yes. Use precise language to list permitted actions and expressly exclude categories you do not want the agent to manage. Include transaction thresholds, successor agents, and revocation methods to reduce interpretation disputes by third parties or courts.
How do I revoke a POA?
Revoke by executing a written revocation, notifying the agent and institutions that hold the POA, and retrieving or destroying originals where possible. File or record revocation if the POA was recorded and retain proof of notice to prevent continuing reliance.
Are electronic signatures valid?
Electronic signatures are legally recognized under the ESIGN Act (15 U.S.C. §7001) and UETA where adopted when the four e-sign validity elements are met: intent, consent, attribution, and retention. Confirm recipients accept eSigned and remotely notarized documents.
When should I consult an attorney?
Consult counsel for complex powers, large estate transfers, elder law concerns, contested capacity, or springing POAs. An attorney helps ensure statutory compliance with Tennessee law and minimizes the risk of later litigation or institutional refusal.

Explore Templates

Divorce Form 1 Pledge of Certificate of Deposit LA Rev Stat Dissolution United States of America v. Midkiff et al. Case No. 219 CV 01597 Michigan Release of Mortgage Articles of Incorporation and Initial Report

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now