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.
Health Care Proxy Form For Virginia
State:
Florida
Control #:
FL-P020
Format:
Word;
Rich Text
Instant download
Description
Free preview
How to fill out Florida Health Care Proxy - Designation Of Health Care Surrogate - Statutory Form?
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FAQ
______ I appoint this person to make decisions about my medical care if there ever comes a time when I cannot make those decisions myself. I want the person I have appointed, my doctors, my family and others to be guided by the decisions I have made in the parts of the form that follow.
A written advance directive shall be signed by the declarant in the presence of two subscribing witnesses and may (i) specify the health care the declarant does or does not authorize; (ii) appoint an agent to make health care decisions for the declarant; and (iii) specify an anatomical gift, after the declarant's death ...
Persons are prioritized in order of healthcare agent, legal guardian or special guardian, next of kin, and close friend.
In Virginia, you do not need an attorney?or even a notary?to complete an Advance Directive. Just two witnesses. Your family may witness the document, even if they are listed as decision makers on the directive.
VA's advance directive is VA Form 10-0137. It includes both a Durable Power of Attorney for Health Care section and a Living Will section. On the VA advance directive form, you can choose how strictly you want your surrogate and health care team to follow the preferences included in your Living Will.