Surrogate Decision Maker Templates
As we navigate through life, there may come a time when we are unable to advocate for our own healthcare decisions. During such moments, having a surrogate decision maker can be crucial. At the forefront of healthcare planning, surrogate decision makers play a vital role in ensuring that our wishes and best interests are upheld.
Also known as healthcare proxies or healthcare agents, surrogate decision makers are entrusted with the responsibility of making medical decisions on behalf of an individual when they are unable to do so. These individuals are appointed in advance through legal documents known as advance directives, living wills, or medical power of attorney forms.
Within our comprehensive collection of surrogate decision maker documents, you will find a wide range of forms tailored to each state's specific requirements. Whether you reside in Indiana, Missouri, West Virginia, Virginia, or Pennsylvania, we have the necessary forms to help you designate a trusted individual to act as your surrogate decision maker.
By utilizing our surrogate decision maker documents, you can rest assured knowing that your healthcare wishes will be honored, even if you are unable to express them at the time. Empower yourself to maintain control over your medical care by appointing a surrogate decision maker today.
Documents:
17
This document allows Indiana residents to choose someone to make healthcare decisions on their behalf if they are unable to do so.
PDF 
Word
This type of document, called a Health Care Proxy Form, is used in New York to appoint a person to make medical decisions on your behalf if you are unable to do so.
This legal form encompasses the orders concerning your wishes about your future medical care in the state of Alabama. The document comes into play in the event of severe medical situations in which you are not able to communicate your wishes or make decisions.
Use this form in the state of Florida for a potential situation when a medical issue leaves you unable to express your wishes about medical treatment.
Use this Illinois-specific form for cases when you are not able to communicate your wishes or make decisions. These may include directions regarding the use of mechanical ventilation or feeding tubes, as well as certain surgeries and medications.
These are Missouri-specific written instructions about future medical care should you become unable to make decisions (for example, unconscious or too ill to communicate).
Download this legal document employed in Virginia that spells out the medical treatments an individual would and would not want to be used to keep them alive. The form also clarifies the preferences for other medical decisions, such as pain management or organ donation.
This document is for Maryland residents and helps them make decisions about their health care. It is a worksheet that guides individuals through the process of determining their preferences for medical treatment and end-of-life care.
This form is used for creating a medical power of attorney and living will in West Virginia. It allows individuals to appoint someone to make medical decisions on their behalf and express their preferences for end-of-life care.
This document allows residents of Virginia to appoint a healthcare agent to make medical decisions on their behalf if they are unable to do so.
In California, this type of form will ensure that the principal legally documents the permittance of specific medically related functions to their selected agent.
This form is used in New Hampshire to allow another individual (usually a close friend or relative) the power to make important medical choices on behalf of the principal.
In Pennsylvania, this form is a legal document confirming that an agent can represent another individual in a medical facility.
This form gives a person in Utah the opportunity to select a medical representative that will be given rights concerning medical treatment and any relevant information that may be required after death.
This type of document allows you to designate someone to make medical decisions for you in Oklahoma if you become unable to do so yourself.
