Health Care Surrogate In Spanish. A health care power of attorney is a type of advance directive in which you name a person to make decisions and speak for you when you are unable to speak for yourself, either permanently or temporarily (i.e., under general anesthesia, under sedation, unconscious, in a coma or a delirium, etc.). This pamphlet will explain each part.
I will notify and send a copy of this document to the following persons other than my surrogate, so they may know who my surrogate is: Below are the health care decision forms that were adopted by the board of health on october 24, 2013 pursuant to the health care decisions act (act 1264 of 2013). (4) appoint the kentucky health care surrogate.
A health care surrogate designation is a legal document that appoints a person to become your “surrogate” if you become incapacitated.
Lets you choose another person to make medical decisions based on your wishes for medical treatment, if you are not able to make your own decisions or if you choose not to make them for yourself. I will notify and send a copy of this document to the following persons other than my surrogate, so they may know who my surrogate is: Designation of health care surrogate: This information will be only accessible to law enforcement in crisis or emergency.