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Suggested form of a Health Care Surrogate, Florida Suggested form of a Health Care Surrogate, Florida Statutes Section 765.203 Designation of Health Care Surrogate Name In the event I have been determined to be incapacitated to provide informed consent for medical treatment and surgical and diagnostic procedures, I wish to designate, as my surrogate for health care decisions: 2019 - State Board of Administration of Florida Jun 06, 2019

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