Health care surrogate form florida 2025

1. Click ‘Get Form’ to open the health care surrogate form in our editor.
2. Begin by entering your full name in the designated fields for Last, First, and Middle Initial. This identifies you as the principal making the designation.
3. In the next section, provide the name and contact information of your chosen health care surrogate. Fill in their address, zip code, and phone number to ensure they can be reached when needed.
4. If applicable, designate an alternate surrogate by filling out their name and contact details in the provided fields. This ensures continuity in decision-making if your primary surrogate is unavailable.
5. Review the statement regarding your understanding of this designation. It’s crucial to acknowledge that this allows your surrogate to make significant health care decisions on your behalf.
6. Optionally, include any additional instructions that may guide your surrogate in making decisions aligned with your preferences.
7. Finally, sign and date the document at the bottom. Ensure you have two witnesses sign as well to validate your designation.

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