Florida Medical Power of Attorney (POA) Form

Florida Health Care Surrogate, which might be known as Advanced Directive, or Medical Power of Attorney, is a document that makes the principal’s designation of an individual to make end-of-life treatment decisions on his or her behalf legitimate. It is highly advisable to appoint your surrogate a person you trust and know well because he or she will be responsible for giving instructions (including, but not limited to withholding or withdrawal of life-prolonging procedures) to your attending doctor when you become incapacitated or unable due to any other circumstances to make sound choices. The medical power of attorney form is often followed by the Living Will, where an adult may express his or her wishes concerning the end-of-life treatment directly to the medical staff. You may opt for completing both documents or choose the one you consider appropriate.

The HCS does not need to be notarized, but it is obligatory to have two adult witnesses present while creating the paper.

Florida power of attorney forms – find out more about powers of attorney that can be used for different assets in the State of Florida.

Florida Laws and Requirements

In Florida, the Health Care Surrogate is regulated by ss. 765.201-765.205 of the State Law.

It is required that the principal (and the surrogate and the witnesses) have reached the age of 18. All of them have to sign the document willfully, the sound of mind, and under no influence. Pay attention: if the principal is not able to provide the signature, he or she may direct another individual to do so in the presence of the witnesses. One of the people witnessing the document can be the principal’s spouse or relative, though another cannot.

According to 765.202 (3) of the Florida State Law, one may designate an alternative surrogate who will become in charge of making decisions about the principal’s medical care in case the original surrogate is unwilling or unable to perform as the principal’s agent.

The surrogate should exhibit special care and concern about the principal and consult medical personnel about withdrawing or withholding only those procedures, which were either indicated by the principal in advance or, if there are no written directives, opt for that type of treatment which is believed to be best for the principal’s interest.

If the principal, being capable of communicating and make choices about his or her healthcare treatment, for any reason decides to revoke the HCS, he or she is supposed to immediately talk to the attending physician and initiate destroying the papers (as well as creating a new directive). Otherwise, the HCS will remain valid and effective until the principal’s death.

Make sure you have provided the following people with a signed copy of the paper:

  • The Surrogate
  • Members of the Family
  • Friends
  • Family Physician (Attending Physician)
  • Your Nursing Home (if appropriate)
  • The Clergy (if appropriate)

Filling Out the Form

Be very careful while submitting the Florida HCS Form. You will find a simple set of instructions leading you through the document’s completion below:

  • Obtain the Template

The document may be found on a web page you consider reliable. In order to get the correct, up-to-date form, use our form building software.

  • Provide Principal’s Data

Begin completing the paper with the full name and age of the principal, stating that he or she initiated the document’s completion, expecting an event of medical coma or incapacitation.
Principal's data part of a Florida medical power of attorney document

  • Designate the Attorney

Continue by naming the chosen agent, establishing your relationship, and entering two of his or her phone numbers (work and home). Provide the complete address of your attorney.
Attorney designation section of mpoa for Florida

  • Indicate an Alternative Surrogate

It is recommended but not obligatory to designate an alternative attorney who will perform the duties presuming that the original agent may happen to be unable (or unwilling) to act as a legal attorney.
Alternative surrogate indication of a Florida medical power of attorney form

  • Submit Additional Instructions

There also exists an option to grant your attorney special powers not described in the document, as well as limitate some if you wish so. If you wish to express your preferences expecting a specific scenario, enter your directives herein, too.
Part for additional instructions of a Florida medical power of attorney

  • Witness the Document

Two witnesses should sign the paper and indicate the date, affirming that it has been created voluntarily and under no pressure.

If you have made certain decisions upon your end-of-life treatment and anatomical gifts, follow up with completing the Living Will, which will support your physician(s) and other people with your choices regarding the use of life-prolonging procedures. Keep in mind that this document will have no force if you are pregnant.
Document witnessing part of a mpoa for Florida

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Published: Nov 19, 2020