Colorado Code
Article 18.5 - Proxy and Surrogate Decision-Makers for Medical Treatment and Health-Care Benefit Decisions
§ 15-18.5-105. Statutory Form for Certificate of Appointment of Surrogate Decision-Makers for Health-Care Benefits

The following statutory form for certificate of appointment of surrogate decision-maker for health-care benefits is legally sufficient:
CERTIFICATE OF APPOINTMENT OF A SURROGATE DECISION-MAKER FOR HEALTH-CARE BENEFITS


Executed this _______ day of _______________, ____.
__________________________
(Attending physician)
(Business address)
(Business phone)
(Business fax)

Source: L. 2006: Entire section added, p. 841, § 5, effective May 4.

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Structure Colorado Code

Colorado Code

Title 15 - Probate, Trusts, and Fiduciaries

Article 18.5 - Proxy and Surrogate Decision-Makers for Medical Treatment and Health-Care Benefit Decisions

§ 15-18.5-101. Legislative Declaration - Construction of Statute

§ 15-18.5-102. Definitions Applicable to Medical Durable Power of Attorney - Applicability

§ 15-18.5-103. Proxy Decision-Makers for Medical Treatment Authorized - Definitions

§ 15-18.5-104. Surrogate Decision-Makers for Health-Care Benefits

§ 15-18.5-105. Statutory Form for Certificate of Appointment of Surrogate Decision-Makers for Health-Care Benefits