A healthcare proxy—formally known in Florida as a Designation of Healthcare Surrogate—is a legal document that allows you to choose someone you trust to make healthcare decisions on your behalf if you become unable to make or communicate those decisions yourself.
The person you appoint is called your healthcare surrogate. Depending on the authority you grant in the document and the circumstances, your surrogate may communicate with medical providers, receive relevant health information, and make medical decisions consistent with your wishes when you cannot speak for yourself.
Many people assume this type of planning is only important for older adults or people with serious medical conditions. In reality, an unexpected accident, illness, or medical emergency can happen at any age. If you are an adult, it is worth deciding who should speak for you before an emergency occurs.
Learn more about how a Florida Healthcare Surrogate Designation can be incorporated into a comprehensive estate plan.
Why Would a Young, Healthy Person Need a Healthcare Surrogate?
In Florida, turning 18 generally means you are legally an adult for purposes of making your own healthcare decisions. Your parents do not automatically retain the authority to make medical decisions for you simply because you are their child.
That can create uncertainty if you are suddenly hospitalized and unable to communicate. Your family may be deeply involved in your life, but being a close relative does not necessarily mean someone has been specifically chosen by you to make healthcare decisions.
A real-world example: Emma's situation
Imagine Emma, a 21-year-old college student, is involved in a serious car accident and arrives at the hospital unconscious. Her parents are understandably worried and want to understand her condition, speak with her doctors, and help with important decisions.
Because Emma is an adult, her parents do not automatically have the same decision-making authority they had when she was a minor. Florida law does provide a process for selecting a healthcare proxy when an adult has not appointed an available surrogate, and HIPAA permits certain disclosures to family members when a patient is incapacitated. However, these rules do not give parents unrestricted access to all medical information or automatically make them the patient's chosen decision-maker.
Having a properly prepared healthcare surrogate designation could help make Emma's wishes and choice of decision-maker clear before a crisis occurs.
The point is not that a family will necessarily be shut out of medical discussions or forced to go to court. Florida law provides a statutory process for identifying a healthcare proxy when no designated surrogate or alternate is available to act. But relying on that process means someone else may be selected under the law's priority rules rather than the person you would have chosen yourself.
What Does a Florida Healthcare Surrogate Do?
A healthcare surrogate is the person you designate to act on your behalf when the authority granted in your document becomes effective. Under Florida law, the surrogate generally follows your instructions and makes healthcare decisions based on what you would have wanted.
Depending on the document and the circumstances, a healthcare surrogate may:
- Communicate with physicians, hospitals, and other healthcare providers.
- Receive relevant medical information and records.
- Make healthcare decisions when you lack the capacity to make them yourself.
- Provide informed consent for appropriate medical treatment.
- Help ensure that your known wishes and treatment preferences are considered.
Florida law directs a surrogate to make decisions in accordance with the principal's instructions and, when those instructions do not address the situation, to consider what the principal would have chosen. If there is no indication of the person's wishes, the surrogate may consider the person's best interests in the circumstances.
Your surrogate does not simply take over because you are hospitalized. Florida law presumes that you are capable of making your own healthcare decisions unless incapacity is determined under the applicable process. While you have decision-making capacity, your own healthcare decisions remain controlling.
When Does Your Healthcare Surrogate's Authority Begin?
One important feature of a Florida Healthcare Surrogate Designation is that you can specify when certain authority begins.
Authority That Begins After Incapacity
You can provide that your surrogate's authority to make healthcare decisions begins after the required determination that you lack the capacity to make those decisions. Under Florida law, the primary or attending physician evaluates your capacity and documents the determination in your medical record.
This approach allows you to remain in control of your own healthcare decisions while you have the ability to make them.
Authority That Begins Immediately
Florida law also allows you to stipulate that your surrogate's authority to receive health information, make healthcare decisions, or both, may be exercisable immediately without waiting for a determination of incapacity.
This is an important distinction. Immediate authority to receive health information is not necessarily the same as immediate authority to make healthcare decisions. Your document should clearly state which authority you intend to grant.
Even when a surrogate has immediately exercisable authority, your own healthcare decisions remain controlling while you have decision-making capacity.
Who Should You Choose as Your Healthcare Surrogate?
Your healthcare surrogate should be someone you trust to take your wishes seriously, communicate effectively with medical professionals, and make difficult decisions under pressure.
Consider choosing someone who:
- Understands your values, beliefs, and healthcare preferences.
- Can remain calm and communicate clearly during stressful situations.
- Is willing and available to take on the responsibility.
- Will advocate for your wishes, even if those wishes are difficult for others to accept.
For some people, the right choice is a spouse or parent. For others, it may be an adult child, sibling, close friend, or another trusted person. The important thing is to choose the person who will best represent your wishes—not simply the person someone else expects you to select.
You may also name an alternate surrogate. An alternate can step in if your first choice is unwilling, unable, or reasonably unavailable to serve. Naming an alternate can help reduce uncertainty if your first choice cannot act when needed.
What Are Florida's Requirements for Signing a Healthcare Surrogate Designation?
Florida Statutes Section 765.202 establishes the requirements for a written designation of healthcare surrogate.
Generally, the document must:
- Be signed by you as the person making the designation, called the principal.
- Be signed in the presence of two subscribing adult witnesses.
- Not use the designated surrogate as one of the witnesses.
- Have at least one witness who is neither your spouse nor your blood relative.
If you are unable to sign the document, Florida law provides a procedure for directing another person to sign your name in your presence and in the presence of the witnesses. An exact copy of the executed document must be provided to your designated surrogate.
You may also designate an alternate surrogate, provided that the alternate designation is explicit. The alternate may assume the surrogate's duties if the original surrogate is not willing, able, or reasonably available to perform them. The document remains effective until you revoke it unless it specifies a termination time.
Because execution requirements matter, it is important to use a document prepared and signed in accordance with Florida law rather than assuming that a generic online form will address your circumstances.
Is a Healthcare Surrogate the Same as a HIPAA Authorization?
Not exactly. These documents and legal concepts can overlap, but they serve different purposes.
A healthcare surrogate designation identifies the person you authorize to make healthcare decisions and may also authorize that person to receive health information. A separate HIPAA authorization can be used to permit healthcare providers to disclose protected health information to specified individuals.
HIPAA does not categorically prohibit doctors from speaking with family members when a patient is incapacitated. Federal privacy rules permit certain disclosures to family members and others involved in a patient's care when the provider determines, using professional judgment, that sharing the information is in the patient's best interest. Those disclosures are generally limited to information relevant to the person's involvement in the patient's care.
However, permission to share information is not the same as authority to make healthcare decisions. A properly prepared healthcare surrogate designation helps clarify who you have chosen to act for you and what authority that person should have.
How Is a Healthcare Surrogate Different From a Living Will?
A Healthcare Surrogate Designation and a Living Will are both Florida advance directives, but they serve different purposes.
A Healthcare Surrogate Designation identifies the person you choose to make healthcare decisions or receive health information within the authority you grant. A Living Will documents your instructions concerning life-prolonging procedures if you have a terminal condition, an end-stage condition, or are in a persistent vegetative state, as defined by Florida law.
These documents work together. Your surrogate can help communicate and carry out your wishes, while your Living Will provides written guidance about specific end-of-life treatment preferences.
What Happens If You Do Not Have a Healthcare Surrogate?
Florida law provides a statutory process for selecting a healthcare proxy when an incapacitated patient has not executed an applicable advance directive, has not designated an available surrogate, or the designated or alternate surrogate is no longer available to make healthcare decisions.
Under Florida Statutes Section 765.401, the individuals who may be considered are listed in a statutory order of priority. If no individual in a prior class is reasonably available, willing, or competent to act, the next qualifying person may be considered. The statutory order includes:
- A judicially appointed guardian or qualifying guardian advocate who has been authorized to consent to medical treatment, if one has previously been appointed.
- The patient's spouse.
- An adult child of the patient or, if the patient has more than one adult child, a majority of the adult children who are reasonably available for consultation.
- A parent of the patient.
- An adult sibling of the patient or, if the patient has more than one adult sibling, a majority of the adult siblings who are reasonably available for consultation.
- An adult relative who has demonstrated special care and concern for the patient, maintained regular contact, and is familiar with the patient's activities, health, and religious or moral beliefs.
- A close friend of the patient.
- A qualifying clinical social worker under the statute's requirements.
This process does not mean that a family must automatically obtain a court-appointed guardian before healthcare decisions can be made. Florida law expressly states that the guardian provision does not require a guardian to be appointed before a treatment decision can be made under the statutory proxy process.
Still, the statutory priority list may not reflect the person you personally would have selected. Naming your own surrogate gives you a meaningful opportunity to make that choice in advance.
How Healthcare Planning Fits Into Your Complete Estate Plan
A healthcare surrogate designation is one part of a broader incapacity and estate planning strategy. Other documents can address different situations that may arise if you become unable to manage your affairs or communicate your wishes.
- Florida Durable Power of Attorney: Names someone to handle authorized financial and legal matters on your behalf if you become unable to manage them yourself.
- Florida Revocable Living Trust: Can provide a framework for managing assets held in the trust during incapacity and distributing them after death.
- Florida Last Will and Testament: Documents your wishes for the distribution of probate assets and can nominate a personal representative and, when appropriate, a guardian for minor children.
- Healthcare Surrogate Designation: Identifies the person you choose to make healthcare decisions within the authority you grant.
These documents serve different purposes and should be coordinated so that your financial, legal, and healthcare decisions are addressed consistently.
The Bottom Line: Healthcare Planning Is for Adults of Every Age
A Florida Healthcare Surrogate Designation is not just a document for seniors. It is an important part of planning for any adult who wants a trusted person to help manage healthcare decisions if an unexpected illness or injury leaves them unable to communicate.
Taking time to choose your surrogate, name an alternate, and clearly explain when their authority should begin can help reduce uncertainty for the people who may need to act on your behalf.
If you are unsure which documents belong in your plan, visit our Florida estate planning FAQs or schedule a conversation to discuss your family's circumstances and planning goals.
Florida and Federal Legal References
- Florida Statutes § 765.202 — Designation of a healthcare surrogate, signing requirements, alternate surrogates, and immediately exercisable authority.
- Florida Statutes § 765.204 — Capacity of the principal and procedure for determining incapacity.
- Florida Statutes § 765.205 — Responsibilities and authority of the healthcare surrogate.
- Florida Statutes § 765.302 — Procedure for making a Living Will.
- Florida Statutes § 765.401 — The statutory healthcare proxy process and priority of individuals who may serve.
- U.S. Department of Health and Human Services — HIPAA and disclosures to family members when a patient is incapacitated.
Published April 7, 2026 | Last reviewed November 3, 2026
Protect Your Wishes. Give Your Family Clarity.
At Marissa Petillo Law, we include a healthcare surrogate designation as part of every comprehensive estate plan we prepare. We help you consider who should make healthcare decisions, how that authority should work, and how your documents fit together to protect your wishes.
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