Healthcare documents that can affect a patient’s wishes — such as powers of attorney — can significantly impact the signer’s medical treatment and finances. To ensure critical healthcare documents are not used to exploit the signer, Notaries should never to notarize under the following conditions: The signer is medicated, confused or otherwise unaware. Notaries in a healthcare setting should always check whether a patient is under the influence of any medication that can affect willingness and awareness before notarizing. Also, if the signer appears drowsy, unaware, or other conditions that make willingness to proceed unclear, halt the notarization and ask to reschedule for a time when the signer is more aware and better able to confirm willingness and awareness. Inappropriate influence by third parties. If the signer’s friends, relatives or other parties are present and appear to be coercing the signer — such as telling the signer to proceed anyway if reluctant, or physically trying to guide the signer’s hand to write on a document — you should ask persons trying to influence the signer to leave so you can privately confirm the signer is willing to sign. If the signer is unwilling, or the third parties are not cooperative, do not proceed. The signer lacks ID. Often signers in a healthcare setting lack easy access to their driver’s license or other satisfactory proof of identity. If asked to notarize healthcare documents for someone, confirm beforehand they will have either ID or credible witnesses available, otherwise the notarization can’t take place. State-required observers aren’t present. Some states have special requirements and restrictions when notarizing documents such as a durable healthcare power of attorney. For example, in California, a power of attorney executed in a skilled nursing facility must be witnessed by a patient advocate or ombudsman. If you are notarizing healthcare documents for a signer in a care facility, check if state laws require a specific third-party observer present before proceeding.