Florida Advance Directive Form (Medical POA & Living Will)

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The Florida Advance Directive lays down an individual’s personal guidelines surrounding medical decisions that may need to be made during an incapacitated state. There are two (2) primary sections of the form that will need to be addressed in order to properly execute the document. The first being the “Living Will” section that allows the main party to provide instructions regarding any life-sustaining treatments. The second portion of the form is called the “Designation of a Health Care Surrogate” which provides the option of appointing a third party to make health care choices on the behalf of the principal. After furnishing the document with the required details, the principal will have to then sign it in the presence of two (2) witnesses in order to obtain their acknowledgment.

This Document Contains:

Laws

Statutes Chapter 765: Health Care Advance Directives

Definition § 765.101(1)

Signing Requirements – Both the “Designation of Surrogate” and “Living Will” portions of the document will require the signing to occur in the presence of two (2) witnesses, one (1) of whom is neither a spouse nor a blood relative of the principal (§ 765.202, § 765.302).

Other Versions (10)

AARP (Caring Connections) Version (Instructions)

Download: Adobe PDF

 

 

 


Baptist Health South Florida Version

Download: Adobe PDF

 

 

 


Five Wishes (Aging with Dignity) Version

Download: Adobe PDF

 

 

 


Florida Catholic Conference Version (Spanish Version & Informational Handout also available)

Download: Adobe PDF

 

 

 


Indian River Primary Care Version

Download: Adobe PDF

 

 

 


Lakeland Regional Health Version

Download: Adobe PDF

 

 

 


Lifecare Directives Version

Download: Adobe PDF

 

 

 


Orlando Health Version

Download: Adobe PDF

 

 

 


Prepare for Your Care Version (also available in Spanish/en Español)

Download: Adobe PDF

 

 

 


Spanish/Español Version

Download: Adobe PDF

 

 

 

Additional Resources

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Mental Health Advance Directive

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POLST Form

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