Florida Healthcare Surrogate Designation: Who Makes Medical Decisions for You

A healthcare surrogate designation tells Florida hospitals and doctors who can make medical decisions for you when you cannot speak for yourself. Without one, Florida's statutory proxy hierarchy applies, and a court-supervised guardianship may be needed if no available proxy can act or relatives dispute authority.

Healthcare Surrogate vs. Living Will

These are two separate documents that do different things.

A healthcare surrogate designation names a specific person to make all medical decisions on your behalf when you are incapacitated. This covers everything from authorizing surgery to choosing between treatment facilities to deciding on rehabilitation options.

A living will states your end-of-life treatment preferences — specifically whether you want life-prolonging procedures when you have a terminal condition, end-stage condition, or are in a persistent vegetative state. It speaks for you, but only in those narrow circumstances.

Most Florida families need both. The surrogate handles the broad range of medical decisions that arise during any incapacity. The living will provides specific instructions for the scenarios the surrogate might face.

Florida Execution Requirements

A healthcare surrogate designation under Florida Statute 765.202 requires:

• The principal's signature (or the signature of someone directed by the principal in their presence)
• Two adult witnesses, at least one of whom is not the principal's spouse or blood relative
• The surrogate must be a competent adult — there is no residency requirement

Notarization is not required by statute but is strongly recommended. Many healthcare facilities and insurance companies request notarized documents as a practical matter.

Who Can Serve as Surrogate

Any competent adult can be designated. Florida law does not require the surrogate to be a family member or a Florida resident. You can name a trusted friend, an adult child who lives out of state, or a professional fiduciary.

You should also name an alternate surrogate in case your primary choice is unavailable, unwilling, or has predeceased you.

What Happens Without a Designation

If you become incapacitated without a healthcare surrogate designation, Florida Statute 765.401 establishes a statutory proxy list. In the absence of an available or willing higher-priority person, or when authority is disputed, the healthcare provider or court looks to this hierarchy:

1. Court-appointed guardian (if one exists)
2. Spouse
3. Adult child (or majority of adult children if multiple)
4. Parent
5. Adult sibling (or majority of adult siblings)
6. Adult relative who has exhibited special care and concern for you and is familiar with your wishes
7. Close friend
8. Licensed clinical social worker or a graduate of a court-approved guardianship program

This sounds orderly, but in practice it creates problems. Divorced spouses who never updated their status, estranged family members, or blended families with competing children can all trigger disputes that delay critical medical decisions.

The HIPAA Authorization

Under Florida Statute 765.202, a healthcare surrogate designation permits the surrogate to access the health information needed to make informed decisions. A separate HIPAA authorization form — signed by you and naming the same surrogate — can reduce friction with facilities and record custodians.

Even with a designation, a facility may request separate HIPAA authorization or other documentation before releasing test results, imaging, or clinical notes.

When to Update

Update your healthcare surrogate designation when:

• You divorce or separate from a spouse named as surrogate
• Your named surrogate dies, becomes incapacitated, or moves far away
• You relocate to Florida from another state (out-of-state documents may be accepted but create friction)
• Your medical preferences change significantly

Divorce generally revokes a former-spouse designation unless the directive or a court order provides otherwise. Review the document after divorce so the intended successor can act.

The Florida Basic Estate Planning Kit includes a healthcare surrogate designation template, a companion HIPAA authorization, and the signing ceremony checklist to execute both correctly.

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