Colorado § 15-18.5-105 - Statutory form for certificate of appointment of surrogate decision-makers for health-care benefits.
Full text of Colorado Colorado Revised Statutes § 15-18.5-105 — Statutory form for certificate of appointment of surrogate decision-makers for health-care benefits., with citation guidance and answers to common questions.
§ 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
(1) I, (name of attending physician), the attending physician, certify that (name of person for whom decisions are being made) lacks the decisional capacity to make health-care benefit decisions. I further certify that I have made the necessary documentation to the medical record.
(2) I, (name of attending physician), the attending physician or designee, hereby appoint (name of surrogate), (driver's license number or state ID number) as the surrogate decision-maker for health-care benefits on behalf of (name of person for whom decisions are being made), (address, city, state) pursuant to section 15-18.5-104, C.R.S.
(3) (Name of surrogate) shall have access to all necessary personal health information as defined by the federal Health Insurance Portability and Accountability Act and any financial information necessary to make appropriate health-care benefit decisions on behalf of (name of person for whom decisions are being made), as provided for in section 15-18.5-104, C.R.S. (Name of surrogate) shall make such decisions in the best interests of (name of person for whom decisions are being made).
Executed this _______ day of _______________, ____.
__________________________
(Attending physician)
(Business address)
(Business phone)
(Business fax)
Source: L. 2006: Entire section added, p. 841, § 5, effective May 4.
15-18.6 ARTICLE 18.6
Directive Relating to Cardiopulmonary Resuscitation
15-18.6-101. Definitions.
15-18.6-102. CPR directives for CPR - who may execute.
15-18.6-103. CPR directive forms - duties of state board of health.
15-18.6-104. Duty to comply with CPR directive - immunity - effect on criminal charges against another person.
15-18.6-105. Effect of declaration after inpatient admission.
15-18.6-106. Effect of CPR directive - absence - on life or health insurance.
15-18.6-107. Revocation of CPR directive.
15-18.6-108. Effect of article on euthanasia - mercy killing - construction of statute.
Source: official Colorado text · Last verified 2026-08-27
Frequently Asked Questions About Colorado § 15-18.5-105
What does Colorado Revised Statutes § 15-18.5-105 cover?
Section 15-18.5-105 ("Statutory form for certificate of appointment of surrogate decision-makers for health-care benefits.") is part of the Colorado Revised Statutes, the codified statutory law of Colorado. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Colorado § 15-18.5-105?
A common citation format is "Colorado Revised Statutes § 15-18.5-105" (Colorado). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Colorado law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Colorado official source linked on this page or consult a licensed Colorado attorney.
How does Colorado § 15-18.5-105 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Colorado can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Colorado.