Health Care Surrogate Form

“Empower yourself by choosing while you still can!”

Your health care surrogate can be any adult of at least 18 years of age who is deemed competent. Choosing your representative must take place with careful consideration because they will be tasked with making tough medical decisions for you if you are incapacitated or otherwise unable to do so. It is recommended to talk over some scenarios with the person you choose to better prepare them for how you would want choices made. If you do not give your surrogate specific instructions, the task of choosing the option that best interests you falls on them.  Contact The Finity Law Firm if you are in need of an Orlando estate planning attorney – we offer free consultations!

Why include this document as part of your estate plan?

The designation of health care surrogate form should be filed with your estate plan because it designates exactly who will make healthcare decisions for you if you are unable to do so. The health care surrogate acts in situations of incapacitation and end-of-life treatment. If you are deemed incompetent, and you have not chosen a health care surrogate, then a particular relative will make your health choices as determined according to state guidelines. There is an order of priority when deciding which family members will represent you.

This order might not be the best for you and could harm you significantly. What if it’s that brother you always hated? Or the ex-spouse you haven’t officially divorced from yet? If you are in a long-term relationship but are not married, the person chosen to act in your place will not be your partner, but rather a parent, child, or sibling. If relatives have conflicting views on what they believe your wishes truly are, then it is best that you make the decision for them and indicate the person you want calling the shots.

How to get a health care surrogate drafted in Florida?

health care surrogate meeting with doctor in office

A designation of health care surrogate document can be drafted in Florida with the guidance of an experienced estate planning attorney. It is always recommended to have any document that represents you, your health, or your property to be drafted by a legal professional to ensure accuracy, clarity, and precision. The form requires your signature and the signature of two witnesses (neither of whom may be the surrogate) in the presence of a notary. At least one witness must also be someone other than your spouse or blood relative. It’s always good to include an alternate for your health care proxy in the event your first choice is unavailable or unable to fulfill the agreement.

Who should be your health care surrogate?

A health care surrogate should be someone you trust with your life. Pick someone you are confident will fulfill your wishes and who is likely to be available when the time comes. Your surrogate can be your spouse, child, parent, relative, friend, or any individual you choose who meets age and competency guidelines. You should have a conversation with your potential surrogate about your desires and feelings towards the difficult decisions that may come up. Find someone that can put your mind at ease knowing your body will be in good hands if the time comes.

How is a health care surrogate document different than a living will?

A healthcare surrogate form differs from a living will in that the former authorizes a chosen individual to make decisions on your behalf, whereas the ladder provides instructions for end-of-life choices and incapacitation care. The two types of documentation can be conflicting, and it is best not to create the two independent of one another.  It is important to consult an estate planning attorney in Orlando should you have any questions about the difference between these two items. The benefit of the surrogate compared to the directive/living will is that the chosen representative will make decisions on your behalf in any situation. The living will may be more specific regarding your wishes, but it cannot encompass all possible scenarios in which a medical decision must occur. Complications could arise if a situation occurs that is not specified in your instructions. To handle an unexpected manner, authorization is necessary by the individual determined appropriate to represent you according to the laws of your state.

What else should you include with a designation of health care proxy form?

Congress created the Health Insurance Portability and Accountability Act (HIPPA) with the intentions of protecting the privacy of your healthcare information. The Act prohibits health care providers from releasing information unless you have provided consent through a HIPAA release form. The HIPAA document provides permission to a health care provider which allows for the release of medical information and medical billing information to any persons you provide access. This form should be included with your health care proxy form to ensure that any person you intended, including your chosen health care surrogate, may have access to all of your health-related information.

Want to talk to an Orlando estate planning attorney about designating a health care surrogate? If so please call the Finity Law Firm at (407) 636-4066, email us at, or fill out our contact form HERE for a FREE consultation.

Explore More

Download Your Free Estate Planning Guide

Learn how to protect your family, your assets, and your legacy.

    • Schedule a Consultation With Our Orlando Law Firm

Download Your

Free Estate Planning Guide

*We take your privacy very seriously.