Medical Power Of Attorney Letter

Medical Power Of Attorney Letter in Word, Google Docs, PDF

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MEDICAL POWER OF ATTORNEY LETTER

The Adams County Hospital
2639 Morgan Street
Adams, Tennessee 37010

RE: Granting of Medical Power of Attorney to Manuel K. Gendron

To whom it may concern:

I, Trevor J. Baker of 4951 Melville Street, Memphis, Tennessee 38141, the Principal, hereby authorize and grant medical powers to Manuel K. Gendron of 2866 Chenoweth Drive, Monterey, Tennessee 38574, the Attorney-in-Fact.

The Attorney-in-Fact shall have the medical power and authority to perform and undertake on my behalf the following acts only:

  • Access my medical records and other health information
  • Agree, refuse, or withdraw medical treatment, surgical procedures, medication, care, and treatment
  • Admit or discharge me from any hospital, nursing home, or any other similar medical care facilities
  • Hire or fire medical service personnel responsible for my care
  • Execute and sign documents, waivers, and other instruments with respect to the medical powers granted

The granted medical powers may be revoked at any time upon authorizing revocation in a written instrument signed by me.

This power of attorney shall be governed by the laws of the State of Tennessee.

IN WITNESS WHEREOF, the Principal and the Agent execute this Power of Attorney as of the date signed below in the state of Tennessee.

Signature *

Trevor J. Baker

Signature *

Manuel K. Gendron

Name *

Name *

SIGNED AND DECLARED by the Principal before our joint presence on the date signed below in the state of Tennessee.

Signature * 

Scott G. Brown

Signature *

Mary J. Martinez

Name *

Name *

SUBSCRIBED AND SWORN to before me this 28th day of August 2025 in the state of Tennessee.

Signature *    
Gerald L. Weiser    
Name *


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