Florida Power Of Attorney For Health Care

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Florida Power of Attorney for Health Care is also referred as Designation for Health Care Surrogate.

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A Florida Designation for Health Care Surrogate (similar to Power of Attorney for Health Care forms used in other states) allows you to appoint another person (referred to as a Surrogate or Designee) to make health care decisions on your behalf if you should become incapacitated. These decisions include medical treatment and surgical and diagnostic procedures.

This is not the same thing as a Living Will or an Advance Directive.

Some of the important provisions included in this Florida Designation for Health Care Surrogate are:
  • Grantor and Surrogate: Names of the Grantor and the Surrogate that is appointed;
  • Alternate Agent: Names of an alternate Agent;
  • Grant of Power: The various powers to make health care decisions granted to the Surrogate;
  • Signature of Grantor: Confirms that these are the wishes of the person whose name appears on the document;
  • Witnesses: Declares that the person whose name is on the document is of sound mind.

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This attorney-prepared form includes:
  1. Information and Instructions for the Designation for Health Care Surrogate
  2. Florida Designation for Health Care Surrogate
State Law Compliant This form was prepared for use in Florida
Number of Pages5
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#19239
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