Power of Attorney (Scotland) - Template, Sample Form
✓ Valid in United Kingdom
Create your Power of Attorney (Scotland) - Template, Sample Form for use in United Kingdom. Answer a few plain-English questions and the document fills in automatically as you go — then download it in Word and PDF, ready to sign or share.
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WELFARE POWER OF ATTORNEY
I, ________, of:
________
make this power of attorney (Power of Attorney) in accordance with the Adults with Incapacity (Scotland) Act 2000 (the Act).
1. APPOINTMENT
1.1. I hereby appoint ________ of:
________
to be my Welfare Attorney in terms of section 16 of the Act and in accordance with the particular powers as defined in this Power of Attorney.
1.2. ________ shall be referred to in this Power of Attorney as "my Attorney".
2. DECLARATION
I declare and confirm the following:
2.1. I intend this Power of Attorney to be a Welfare Power of Attorney in terms of section 16 of the Act.
2.2. I am habitually resident in Scotland and this Power of Attorney shall be governed by and interpreted in accordance with the laws and jurisdiction of Scotland.
2.4. I have considered how my incapacity will be determined and confirm that it is my wish for this to be established and certified in writing by one qualified medical practitioner.
2.5. My Attorney shall be authorised to exercise the welfare powers in accordance with section 3 (Welfare Powers) until:
2.5.1. they receive written notice that I have revoked this Power of Attorney; OR
2.5.2. the Power of Attorney is terminated by operation of any provision of the Act or any other lawful reason.
2.6. At all times my Attorney shall be subject to the requirements of the Act.
3. WELFARE POWERS
My Attorney shall have the Welfare Powers as set out and defined in this section (section 3 ).
3.1. Medical treatment and personal arrangements
3.1.1. My Attorney may make decisions and act on my behalf in respect of any matter relating to my general welfare and care arrangements.
3.1.2. My Attorney may consent on my behalf to any medical treatment or health-related treatment, provided that this is not prohibited by the Act.
3.1.3. My Attorney may refuse consent on my behalf to any medical treatment or health-related treatment.
3.1.4. My Attorney may consent or refuse consent to medical research, within the parameters of the Act.
3.1.5. My Attorney may make decisions about my living arrangements and accommodation and may implement any such decision on my behalf.
3.1.6. My Attorney may make decisions in respect of my personal care, including my clothes, personal appearance and diet.
3.2. Confidential information
3.2.1. My Attorney may have access to all personal or confidential information, documents and data (Personal Information) held by any organisation or body which relates to my personal health and welfare.
3.2.2. My Attorney may disclose my Personal Information to any third party where this is reasonably necessary and in my best interests.
3.3. Digital information
3.3.1. My Attorney may monitor and manage any online or email accounts held by me and access any digital information held in relation to me however my Attorney must not post on any online site in my name, holding themselvess out as me.
3.3.2. My Attorney may contact online internet or email service providers to obtain and manage my login details for any online or email account and I authorise any such provider to release information to my Attorney.
3.4. Legal action
3.4.1. My Attorney may pursue, defend, settle or compromise any legal action relating to my personal welfare on my behalf.
3.5. Social, cultural and educational activities
3.5.1. My Attorney may decide which social, cultural or religious meetings or activities I may take part in.
3.5.2. My Attorney may make decisions about my social groups and may decide with whom I may socialise or associate.
3.5.3. My Attorney may decide which educational or vocational activities I may take part in and may make arrangements for me to attend any such activities.
3.5.4. My Attorney may take me on trips and holidays and may authorise and arrange for others to do so.
4. GENERAL PROVISIONS4.1. My Attorney shall act at all times in accordance with the principles set out in section 1 of the Act and shall have regard to my present and past wishes and feelings, in so far as these can be ascertained.
4.2. In exercising any power conferred by this Power of Attorney, my Attorney shall take account of the views of any other person whom they consider it reasonable and practicable to consult, including my nearest relative, my primary carer and any guardian or attorney with an interest in my welfare.
4.3. My Attorney shall, in so far as it is reasonable and practicable to do so, encourage me to exercise whatever skills I have concerning my personal welfare and to develop new such skills.
4.4. Any benefit or intervention exercised by my Attorney under this Power of Attorney shall be the least restrictive option in relation to my freedom that is consistent with the purpose of the intervention.
4.5. Where I have appointed more than one Attorney, my Attorneys shall, unless otherwise specified in this Power of Attorney, act jointly and severally in the exercise of the Welfare Powers.
4.6. My Attorney shall not be entitled to any remuneration for acting as my Attorney but shall be entitled to be reimbursed for all reasonable outlays properly incurred in the exercise of their functions under this Power of Attorney.
5. EXECUTION
In witness whereof this power of attorney consisting of this and the proceeding pages above executed by me as follows:
SIGNED
______________________________
________
IN THE PRESENCE OF
FULL NAME OF WITNESS:
______________________________
WITNESS SIGNATURE:
______________________________
WITNESS ADDRESS:
______________________________
ON
DATED OF SIGNING:
_____________________________
AT
LOCATION OF SIGNING:
____________________________
SCHEDULE 1
STATUTORY CERTIFICATE
The statutory certificate from the Office of the Public Guardian MUST be completed and attached below.
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