Florida Medical Power of Attorney Form

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The Florida Medical Power of Attorney, or as the state calls it, the “Designation of Health Care Surrogate”, is the assignment of powers to another individual that enables them to make medical judgment calls on the behalf of the principal. This only goes into effect if the assignor loses their mental capacity and is unable to voice their preferred course of action. To exercise this document accordingly, the principal must supply the name & address of their attorney-in-fact (and of a successor agent if they wish), instructions for their health care priorities, and their signature along with the endorsement of two (2) witnesses.

Other Versions (4)

Florida Medical Power of Attorney – Version 1

Download: Adobe PDF

 

 

 


Florida Medical Association Version

Download: Adobe PDF

 

 

 


Florida Medical Clinic Version

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Naples Community Hospital Version

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Additional Resources

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Living Will

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POLST Form

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Download: Adobe PDF