Florida Medical Power of Attorney Form (Designation of Health Care Surrogate)

The Florida Designation of Health Care Surrogate Form, also known as a “Medical Power of Attorney,” is the official state form created by the Florida Bar and Florida Medical Association for nominating a surrogate (trusted individual) to make medical decisions for the person that completes the form (known as the “principal”). With the form, the principal can nominate a main surrogate and an alternate surrogate, should the first surrogate not be able to complete their duties.

The form gives those that complete it peace of mind knowing that their health care choices will be respected when (or if) they are unable to communicate them due to a serious medical condition. It is recommended that anyone who is considering enacting the POA should do so sooner than later, as all states require for it to be drafted and executed before the principal becomes incapacitated.


State Laws & Signing Requirements

State Laws: Health Care Advance Directives (§§ 765.101 – 765.547)

Signing Requirements (§ 765.202): The principal must sign the POA in the presence of two (2) witnesses. It is also recommended that the form be notarized as well to ensure its legitimacy.

Additional Information: Included in the download are instructions that inform the principal on how to complete the form. The following are important things to note regarding the POA:

  1. The surrogate cannot act as one of the two (2) witnesses.
  2. The form can be revoked orally or by use of a revocation of POA.
  3. Once completed, the form should be given to the principal’s physician and/or medical institution for record-keeping purposes.