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DESIGNATION OF HEALTH CARE SURROGATE I, s.765.202, Florida Statutes: Name: Address: Phone:, designate as my health care surrogate under my health care surrogate is not willing, able, or reasonably
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To fill out the designation of health care, follow these steps:
02
Start by clearly identifying the patient for whom the designation is being filled out.
03
Include the patient's full name, date of birth, and any other relevant identifying information.
04
Specify the designated health care agent or proxy who will make medical decisions on behalf of the patient.
05
Provide the contact information of the designated agent, including their full name, address, phone number, and email.
06
Indicate the effective date of the designation, which is when the agent's authority begins.
07
Include any specific limitations or instructions for the designated agent, if applicable.
08
Sign and date the designation form in the presence of witnesses, as required by law.
09
Keep a copy of the completed designation of health care for your records, and provide a copy to the designated agent, the patient's primary care physician, and any other relevant healthcare providers.

Who needs designation of health care?

01
Designation of health care is needed by individuals who want to ensure that their medical decisions are made according to their wishes in case they become incapacitated or unable to communicate their preferences.
02
This includes individuals with chronic illnesses, elderly individuals, individuals with terminal conditions, and anyone who wants to have control over their healthcare decisions.
03
The designation allows individuals to appoint a trusted person as their health care agent, who will advocate for their medical preferences and ensure that their wishes are respected.
04
It is also recommended for individuals planning major surgeries or medical procedures, individuals with strong preferences regarding their medical treatment, and those who want to alleviate the burden of decision-making from their family members.
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Designation of health care is a legal document that allows individuals to appoint a specific person to make medical decisions on their behalf in the event they are unable to do so.
Any individual who wishes to appoint a health care proxy to make medical decisions on their behalf should file a designation of health care.
To fill out a designation of health care, individuals need to obtain the appropriate form, provide their personal information, specify their health care proxy, and sign the document in accordance with their state's requirements.
The purpose of designation of health care is to ensure that an individual's medical preferences are honored and that a trusted person can make health care decisions for them when they are incapacitated.
The designation of health care must include the appointing individual's name, the name of the chosen health care proxy, and details of any specific preferences regarding medical treatment.
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