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DESIGNATION OF HEALTH CARE SURROGATE INFORMATION, Designate as my health care surrogate under S. 765.202,Florida Statutes: Name: Address: Phone: If my health care surrogate is not willing, able or

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How to fill out designate as my health

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Step 1: Open the designate as my health form

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Step 2: Enter your personal information such as name, address, and contact details

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Step 3: Provide details about your health conditions, medical history, and any specific requirements

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Step 4: Review the form for accuracy and completeness

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Step 5: Sign and date the form

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Step 6: Submit the form to the designated authority or healthcare provider

Who needs designate as my health?

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People who want to designate their health preferences and decisions in advance

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Individuals with chronic illnesses or complex medical conditions

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Elderly individuals who may require medical care in the future

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Anyone who wants to have control over their medical treatment and care

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