In the event you do not want to use the illinois statutory form provided here, any document you complete must be executed by you, designate an agent who is over 18 years of age and not prohibited from serving as your agent, and state the agent's powers, but it need not be witnessed or conform in any other respect to the statutory health care power. You can use this document to authorize an agent to make almost any healthcare decision for you, including authorizing or withdrawing medical treatment for any mental or physical condition. Communication Of Health And Safety In The Workplace Pdf This document gives someone else the authority to make decisions on your behalf should you become mentally incapacitated. Illinois health care power of attorney form . Illinois power of attorney that lets an illinois resident complete transferring power to another person, the “agent”, allowing the agent to make decisions or act on the resident’s behalf. Hopefully this helps solve both problems....