This form allows you to designate a surrogate to make health care decisions for you if you are determined to be incapacitated to provide informed consent for medical treatment and surgical and diagnostic procedures.
Florida Health Proxy Form With Two Points
State:
Florida
Control #:
FL-P020
Format:
Word;
Rich Text
Instant download
Description
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How to fill out Florida Health Care Proxy - Designation Of Health Care Surrogate - Statutory Form?
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FAQ
Make sure your proxy knows the names and contact information for your primary care provider and any other providers . Make sure your primary care provider knows the name and contact information for your proxy . Being a good proxy means speaking for the person when they're unable to speak for themselves.
No, you do not need to notarize your designation, but you will need to sign the designation before two witnesses and have the witnesses attest to your signature. At least one of the witnesses must not be a blood relative. After you and the witnesses have signed, your designated surrogate should receive a copy.
If you become unable to make your own healthcare decisions and do not have a legal guardian or someone designated under a Medical Power of Attorney, then certain family members and others can make medical treatment decisions on your behalf. An advance directive does not need to be notarized.
If you're not named a health care surrogate Florida law directs your doctor to use the following list to determine a decision maker for you: Guardian (only if one has been appointed by a court) Your spouse. Your adult child or children.
Here's the pertinent language: Every competent adult shall have the right to appoint a health care agent by executing a health care proxy. The provision goes on to permit the appointment of an alternate agent, but does not speak of appointing multiple agents at the same time.