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Florida Certification of Person's Incompetence to Consent to Treatment and Notification of Health Care Surrogate/Proxy

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State:
Florida
Control #:
FL-S023ST
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Word; 
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Description

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 Certification of Person's Incompetence to Consent to Treatment and Notification of Health Care Surrogate/Proxy is a legal document used in the state of Florida to designate a health care surrogate or proxy to act on behalf of an individual who has been deemed legally incapacitated or incompetent to make decisions regarding his or her own medical care. The form includes a section for the designation of a health care surrogate, who must be 18 years or older and able to make healthcare decisions on the patient's behalf. In addition, the form includes a section for the designation of a proxy, who may be a person or an entity such as a lawyer, a guardian, or a healthcare provider. It is important to note that the health care surrogate and proxy designation will only be valid if the individual signing the form has been declared legally incompetent, and that the declaration must be made by two qualified physicians. The two main types of Florida Certification of Person's Incompetence to Consent to Treatment and Notification of Health Care Surrogate/Proxy are the Notice of Designation of Health Care Surrogate and the Notice of Designation of Proxy. The Notice of Designation of Health Care Surrogate is used to designate an individual to make medical decisions on behalf of a legally incompetent person. The Notice of Designation of Proxy is used to designate who will receive notification of any health care decisions made on behalf of a legally incompetent person.

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FAQ

The health care proxy statute provides the legal ability for the family and others to take over someone's health decisions if the incapacitated person is unable to make health care decisions themselves.

Does a Designation of Health Care Surrogate Need to be Notarized? 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.

(19) ?Proxy? means a competent adult who has not been expressly designated to make health care decisions for a particular incapacitated individual, but who, nevertheless, is authorized pursuant to s. 765.401 to make health care decisions for such individual.

Health Care Proxy Florida law enables these individuals to make health care decisions for a person, in descending order of priority: Guardian. Spouse. Adult child, or if more than one, a majority of the adult children who are reasonably available for consultation.

(1) A principal is presumed to be capable of making health care decisions for herself or himself unless she or he is determined to be incapacitated.

The alternate surrogate may assume his or her duties as surrogate for the principal if the original surrogate is not willing, able, or reasonably available to perform his or her duties. The principal's failure to designate an alternate surrogate shall not invalidate the designation of a surrogate.

Designation of a health care surrogate. (1) A written document designating a surrogate to make health care decisions for a principal shall be signed by the principal in the presence of two subscribing adult witnesses.

PURSUANT TO SECTION 765.204(3), FLORIDA STATUTES, ANY INSTRUCTIONS OR HEALTH CARE DECISIONS I MAKE, EITHER VERBALLY OR IN WRITING, WHILE I POSSESS CAPACITY SHALL SUPERSEDE ANY INSTRUCTIONS OR HEALTH CARE DECISIONS MADE BY MY SURROGATE THAT ARE IN MATERIAL CONFLICT WITH THOSE MADE BY ME.

More info

Recommended form CF-MH 3122, Feb. A Florida health care surrogate designation is signed before you become incapacitated while a health care proxy is when no surrogate was ever named.Power Of Attorney For Health Care. Power Of Attorney For Health Care. Advance directive is a term that refers to a person's spoken and written instructions about future medical care and treatment. The Proxy law allows a competent adult to name "an agent" and "an alternate. Minnesota law allows you to inform others of your health care wishes. 0645 Other persons who may consent to medical care or treatment of a minor.--.

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Florida Certification of Person's Incompetence to Consent to Treatment and Notification of Health Care Surrogate/Proxy