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Review Dates:Illinois College of Optometry and Illinois Eye Institute
Establishing a Surrogate Decision Maker
Patient and Family Education
July 1998
March
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How to fill out establishing a surrogate decision

How to fill out establishing a surrogate decision:
01
Begin by gathering all the necessary documents and information. This may include identification documents, medical records, and any legal documentation pertaining to the person for whom the surrogate decision is being established.
02
Research the specific requirements and guidelines for establishing a surrogate decision in your jurisdiction. This may involve contacting the relevant government agency or seeking legal advice.
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Fill out the necessary forms or documents with the required information. This may include details such as the person's name, date of birth, and contact information, as well as information about the surrogate decision maker.
04
Provide any supporting documentation or evidence that may be required. This could include medical reports, assessments, or statements from healthcare professionals.
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Review the completed forms and ensure all information is accurate and complete. Make any necessary corrections or additions before submitting them.
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Submit the completed forms and any supporting documentation to the appropriate government agency or authority. Follow any specific instructions regarding submission methods or deadlines.
Who needs establishing a surrogate decision:
01
Individuals who are unable to make decisions for themselves due to physical or mental incapacity may need to establish a surrogate decision.
02
This could include individuals with severe cognitive impairments, mental illnesses, or those who are in a coma or vegetative state.
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Establishing a surrogate decision ensures that a designated individual or entity can make decisions on behalf of the incapacitated person, taking into consideration their best interests and personal values.
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What is establishing a surrogate decision?
Establishing a surrogate decision is the process of legally appointing someone to make medical or financial decisions on behalf of an individual who is unable to do so themselves.
Who is required to file establishing a surrogate decision?
The family members or legal guardians of the individual who is unable to make decisions for themselves are required to file establishing a surrogate decision.
How to fill out establishing a surrogate decision?
To fill out establishing a surrogate decision, you will need to complete the necessary forms provided by the relevant authorities and submit them along with any required documentation.
What is the purpose of establishing a surrogate decision?
The purpose of establishing a surrogate decision is to ensure that someone is legally authorized to make decisions on behalf of an individual who is incapacitated or unable to do so themselves.
What information must be reported on establishing a surrogate decision?
The information that must be reported on establishing a surrogate decision typically includes the name of the surrogate decision maker, the reason for the appointment, and the specific powers granted to them.
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