Affidavit of Health Care Proxy. I,. , am willing to serve as a health care proxy for . |
Florida law provides a sample of each of the following forms: a living will, a health care surrogate, and an anatomical donation. Elsewhere in this pamphlet we ... |
Access my health information reasonably necessary for the health care surrogate to make decisions involving my health care and to apply for benefits for me. |
Declaration of Medical Proxy. Under Florida Statutes 765.401 a medical proxy can be appointed to an. :incapacitated or developmental disabilities patient". |
A health care proxy is used in Florida when someone is incapacitated and has not created a designation of health care surrogate. |
The forms included on the Florida Agency for Health Care Administration's Health Care Advance Directives Consumer Guide (scroll down to find the downloadable ... |
The suggested form of this instrument has been provided by the Legislature within Florida Statutes Section 765.203. How do I designate a Health Care Surrogate? |
Decide to make an anatomical gift pursuant to part V of chapter 765, Florida ... Access my health information reasonably necessary for the health care surrogate. |
These forms allow you to designate a person to make medical decisions for you (adult form) or your child (minor form) if you are unable to make them yourself. |
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