Directive to Physician's adn Family Surrogates 2026

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  1. Click ‘Get Form’ to open the Directive to Physicians and Family Surrogates in the editor.
  2. Begin by filling in your name at the top of the form, ensuring that you clearly identify yourself as the declarant.
  3. In the treatment preferences section, carefully read each option regarding terminal conditions and irreversible conditions. Check the box that aligns with your wishes for medical treatment.
  4. If you have specific treatment requests, utilize the additional requests section to detail any treatments you do or do not want under certain circumstances.
  5. Designate a representative by filling in their name, address, and telephone number. You may also list a second alternate person if desired.
  6. Sign and date the document at the bottom. Ensure two competent adult witnesses sign as well, or opt for notarization if preferred.

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This is an important legal document, known as an Advance Directive. It is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values.
A Power of Attorney can grant authority over only financial decisions, only health care decisions, or power over both. Similarly, a Health Care Surrogate is also a person to whom the authority to make medical decisions for another is granted should they be unable to do so themselves.
If a person is unable to make decisions about personal health care, some other person or people must provide direction in decision making. The general term for such person is surrogate decision maker.

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A durable power of attorney for healthcare may also be called a medical power of attorney or healthcare power of attorney. This document, which should be docHubd, designates a proxy or surrogate to act as a decision maker for your care and treatment in the event you are incapacitated by illness or injury and
What is a Health Care Surrogate? A health care surrogate is an adult who is appointed to make healthcare decisions for you when you become unable to make them for yourself.
Your health care surrogate is a person you authorize via a Designation of Health Care Surrogate form to make medical decisions for you when you are unable to make your own decisions. It is important that you discuss your wishes in advance with your health care surrogate.
Any health care surrogate agent is granted the same rights in regard to access of medical information and decision-making as would the alert and competent patient. These rights remain until such time as the client regains decisional capacity, a guardian is appointed, or the patients death occurs.
Traditionally, there are two main kinds of advance directives: the living will and the Durable Power of Attorney for Healthcare. California also allows the use of a POLST (Physicians Orders For Life-Sustaining Treatment).

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