What Is a Designation of Health Care Surrogate in Florida and Why Every Adult Needs One

When people think about “estate planning,” they usually focus on who inherits the house, the bank accounts, or the family business. Very few ask a far more urgent question: Who will speak for me if I am in a hospital bed and cannot speak for myself?

In Florida, the document that answers that question is called a Designation of Health Care Surrogate. It is one of the simplest, most powerful tools in a Florida estate plan, and the one most families wish they had in place before a medical crisis, not after.

At Yergey and Yergey, P.A., we routinely see how this single document can spare Central Florida families from confusion, delay, and even courtroom battles at already‑stressful moments.

What Is a Designation of Health Care Surrogate?

A Designation of Health Care Surrogate is a written advance directive authorized by Florida law that allows an adult (the “principal”) to appoint a trusted person (the “surrogate”) to make health‑care decisions and access medical information if the principal is unable to do so.

Florida Statute section 765.202 expressly permits any competent adult to designate a surrogate to make health‑care decisions consistent with the principal’s instructions and best interests and to receive medical information on the principal’s behalf. In plain English, this is your legally recognized medical decision‑maker when you cannot decide or communicate on your own.

Most well‑drafted designations also name one or more alternate surrogates who can step in if the first choice is unwilling, unable, or unavailable to serve.

When does the surrogate’s authority begin?

Florida law gives you flexibility in structuring when your surrogate’s powers become effective:

• Immediate authority: The surrogate’s authority begins as soon as you sign the document, but you continue to make your own decisions as long as you have capacity. The surrogate can help with insurance issues, scheduling, and information‑sharing even before a crisis.

• Springing authority: The surrogate’s authority “springs” into effect only upon your incapacity, usually determined by your attending physician.

Both options are permitted; which is better depends on your health, your level of trust in the surrogate, and your broader estate plan.​

Who can serve as your surrogate?

Your surrogate must be an adult. Most Floridians choose a spouse, partner, adult child, sibling, or close friend who:

• Understands their values and wishes

• Can remain calm and level‑headed in emergencies

• Is willing to ask questions and work collaboratively (and sometimes firmly) with medical providers

What Powers Can a Health Care Surrogate Exercise?

A properly drafted Designation of Health Care Surrogate can give your surrogate broad authority to act in almost all health‑care matters, including the power to:

• Consent to, refuse, or withdraw medical treatments and procedures

• Access and review your medical records and communicate with physicians, hospitals, and other providers (HIPAA authority)

• Choose or change doctors and facilities, including moving you to rehabilitation, assisted living, long‑term care, or hospice

• Make decisions regarding surgery, medications, diagnostic tests, and rehabilitation plans

• Apply for public benefits related to medical care, such as Medicare or Medicaid, when you authorize it

By statute, your surrogate must follow any instructions you have written and, where your wishes are unknown, must act in your best interests.

It is important to understand that a Designation of Health Care Surrogate is not the same as:

• A Do‑Not‑Resuscitate (DNR) order

• A physician’s order for life‑prolonging treatment (POLST)

• A pre‑need guardian designation

• A will or trust

Those documents may complement a surrogate designation, but they serve distinct purposes and are governed by different legal requirements.

Execution Requirements Under Florida Law

Florida imposes specific formalities to ensure that a Designation of Health Care Surrogate is valid:

• The document must be in writing.

• The principal must sign it or direct another person to sign on the principal’s behalf in the principal’s presence.

• The signature must be witnessed by two adult witnesses.

• At least one witness cannot be a spouse or blood relative.

• The person being designated as surrogate may not act as a witness.

Florida statutes do not require notarization for a Designation of Health Care Surrogate, but many attorneys recommend notarizing and executing it alongside the rest of your estate‑planning documents to reduce the risk of later challenges.

The principal may revoke the designation at any time while having capacity, orally or in writing, or by executing a new designation that supersedes the old one.

Why a Designation of Health Care Surrogate Is Essential

1. Preventing confusion and delay in a medical crisis

Without a valid surrogate designation, Florida’s default statutory hierarchy determines who may make your health‑care decisions. This can create confusion especially in blended families, second marriages, or situations where relatives disagree about what should be done.

Hospitals and doctors may not know which family member has authority, leading to delays at exactly the time when clarity matters most. A written designation tells the medical team exactly who should be consulted, reducing conflict and helping decisions get made more quickly and confidently.

2. Avoiding unnecessary guardianship proceedings

If there is no appropriate surrogate or if family members cannot agree, loved ones may have to pursue a guardianship proceeding just to obtain authority to make medical decisions on your behalf.

Guardianship can be an important tool in some cases, but it is more time‑consuming, expensive, and intrusive than simply honoring the wishes of a competent adult expressed in a properly executed Designation of Health Care Surrogate. Having this document in place can, in many situations, avoid the need for a guardianship focused solely on health‑care decision‑making.

3. Ensuring your values.

Medical crises often involve difficult trade‑offs: length of life vs. quality of life, aggressive treatment vs. comfort, home care vs. facility care. A surrogate who knows you well and has discussed your wishes is far better positioned to make decisions consistent with your values than a distant relative, a court‑appointed guardian, or hospital policy.

You can provide written guidance within the designation or in a separate living will, addressing issues such as:

• Life‑prolonging procedures and artificial nutrition/hydration

• Pain management and sedation preferences

• Religious beliefs and cultural practices

• Organ donation wishes

• Preferences about where you receive care (home, hospital, hospice)

These conversations, combined with a clear legal document, give your surrogate the confidence to advocate for you when you cannot advocate for yourself.

4. Critical protection for young adults, not just seniors

One persistent misconception is that only older adults need a Designation of Health Care Surrogate. In reality, the moment a child turns 18, parents lose automatic legal authority to direct that child’s medical care.

For college students and young professionals, a simple surrogate designation ensures that someone they trust, often a parent or close relative, can receive information and make decisions if there is an accident or sudden illness while they are away at school or traveling. Without one, parents may find themselves blocked by privacy rules at exactly the wrong time.

5. Reducing family conflict when opinions differ

Families may share love but not always the same opinions about medical care. Adult children may disagree with each other or with a second spouse about what Mom or Dad would have wanted.

A properly executed Designation of Health Care Surrogate cannot guarantee family harmony, but it gives clear legal authority to one decision‑maker, guided by the principal’s expressed wishes. That clarity alone often prevents disputes from escalating or spilling into court.

Common Misconceptions That Keep People from Signing One

Despite its importance, many Floridians never sign a Designation of Health Care Surrogate because of simple misconceptions:

• “My spouse or kids can automatically decide for me.” Florida’s default surrogate statute provides a priority list, but it does not eliminate disagreements, and the person the law elevates may not be the person you would choose.​

• “I’m healthy and young, so I don’t need this yet.” Crises such as accidents, strokes, and sudden illnesses do not check birthdates. Advance directives are inexpensive insurance against the unexpected.​

• “I already have a will, so I’m covered.” A will only controls what happens to your property after you die; it says nothing about who makes medical decisions while you are alive but incapacitated.

• “The hospital will just do what’s best.” Providers are bound by medical standards and policies, not your personal values or religious beliefs. Only a surrogate who knows you and has the legal authority can press for the treatment approach that best aligns with your wishes.

How a Health Care Surrogate Fits Into a Complete Florida Estate Plan

At Yergey and Yergey, P.A., we do not treat a Designation of Health Care Surrogate as a one‑off form to sign and forget. It is part of a broader incapacity and estate‑planning package tailored to your situation. A typical Florida plan may include:

• Designation of Health Care Surrogate – medical decisions and access to information

• Living Will – directions regarding life‑prolonging procedures and end‑of‑life care

• Durable Power of Attorney – financial and legal decisions during incapacity

• HIPAA authorizations – additional permission for providers to share information with designated individuals

• Last Will and Testament – directions for distributing probate assets at death

• Revocable Living Trust (where appropriate) – probate avoidance, asset management during incapacity, and privacy

By designing these documents at the same time, we ensure they are consistent, comprehensive, and practical for your family to use in real‑world situations.

When Should You Review or Update Your Designation?

Even the best advance directive cannot remain current forever. You should consider reviewing and updating your Designation of Health Care Surrogate when:

• You move to or from Florida

• You marry, divorce, or start a new long‑term relationship

• Your chosen surrogate becomes ill, moves away, or dies

• You have significant changes in health, values, or religious beliefs

• It has been more than five years since you last reviewed your estate‑planning documents

A quick review can confirm that your chosen surrogate is still the right person and that your instructions remain accurate and complete.

Taking the Next Step With Yergey and Yergey, P.A.

If you live in Orlando or the greater Central Florida area and do not yet have a Designation of Health Care Surrogate or if your existing document is old, incomplete, or part of a piecemeal plan, it may be time for a comprehensive review.

Our firm helps clients integrate advance directives with wills, trusts, guardianship planning, and probate‑avoidance strategies, with a particular focus on incapacity planning and preserving family harmony. We walk you through the practical “what really happens” scenarios so your surrogate and your family are not left guessing when it matters most.

To discuss a Designation of Health Care Surrogate or a broader estate‑planning review, contact Yergey and Yergey, P.A. to schedule a consultation.