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Free Florida Designation of Health Care Surrogate Form
A Designation of Health Care Surrogate names the person who makes medical decisions for you if you can't speak for yourself. It's the medical counterpart to a durable power of attorney — one covers money, the other covers care.
Attorney-reviewed form
We'll send the current, Florida-compliant version — reviewed by our office so you don't ship an invalid one.
What it does
- Names a surrogate to make health care decisions when you're unable.
- Can allow the surrogate to act immediately, or only on incapacity — your choice.
- Can authorize access to your medical records (HIPAA).
- Pairs with a living will to cover end-of-life wishes.
— Florida requirements
Make it valid in Florida.
- In writing, signed by you in the presence of two adult witnesses (Fla. Stat. § 765.202).
- At least one witness must not be your spouse or a blood relative.
- Your named surrogate cannot act as one of the witnesses.
- No notary is required — but the witness rules are strict, and getting them wrong invalidates the form.
How to fill it out
- 1Choose your surrogate and an alternatePick someone who will honor your wishes and can be reached quickly.
- 2Decide when it takes effectImmediately, or only when a physician determines you can't decide for yourself.
- 3Add HIPAA accessAuthorize your surrogate to see the medical records they'll need to decide.
- 4Sign before two qualifying witnessesAt least one witness must be unrelated and not your spouse; your surrogate can't be a witness.
- 5Give copies to your surrogate and doctorKeep one accessible — an unfound form helps no one in an emergency.
Mistakes that void it
- Both witnesses being relatives — at least one must be neither spouse nor blood relative.
- Letting the surrogate sign as a witness (not allowed).
- Confusing it with a living will — the surrogate names who decides; the living will states what you want.
- Never giving a copy to the surrogate or physician.
Questions people ask
Does a Florida health care surrogate form need to be notarized?
No. Florida requires two adult witnesses, at least one of whom is not your spouse or a blood relative (Fla. Stat. § 765.202). A notary is not required.
What's the difference between a health care surrogate and a living will?
The surrogate designation names the person who makes your medical decisions. A living will states your wishes about life-prolonging treatment. Most people sign both.
Rather have it done right?
A form is only as good as how it's executed. We draft and supervise signing so it holds up when it matters — flat fee, from $200. No surprises.