Every person has the right to have an advance directive. An advance directive is a document that you should fill out before you need hospitalization. It designates how you want your healthcare to be delivered in the event that you are not mentally or physically able to make that decision yourself.

It also allows you to name a trusted person to make these choices for you if you become unable to do so. Without an advance directive, someone you may not know could make decisions about important healthcare choices, such as extraordinary life-support, cardiopulmonary resuscitation (CPR), feeding tubes or a ventilator for artificial breathing.

An advance directive may include:

During the admission process at Bayfront Health St. Petersburg, you will be asked if you have an advance directive. If you have one, please bring the forms with you to the hospital admitting office when you check in. If you do not, you may ask for information about a living will and/or healthcare surrogate and the appropriate forms. Your nurse or a social worker also can provide you with the forms.

A Living Will

A living will is a written statement that generally states the type of medical care you want or do not want if you become unable to make your own decisions. It is called a “living” will because it takes effect while you are still living. Under Florida law, you may make a living will and direct the providing, withholding or withdrawal of life-prolonging procedures in the event that you have any of the following:

Healthcare Surrogate

A healthcare surrogate form is a signed, dated and witnessed document naming another person such as a husband, wife, son, daughter or another close relative or friend as your agent to make medical decisions for you if you become unable to make them yourself. Following your wishes, a healthcare surrogate can give informed consent, review medical records, talk with doctors, authorize transfer, apply for public healthcare benefits and consent to organ and tissue donation. You also can include instructions about any treatment you do not want. You may name a second person to stand in if your first choice is not available.

Power of Attorney

A power of attorney is a legal document that allows someone to act as your agent, usually for business and financial matters. You may specify that this person can make healthcare decisions for you.

You may complete the advance directive found in this informational packet, print it out and bring it to the Admissions Department at Bayfront Health St. Petersburg to be included in your medical records.