CONDITIONING: I understand that completing this authorization form is voluntary. I realize that treatment will not be denied if I refuse to sign this form.To learn more about the licensure process, select the type of license you wish to apply for from the list of professions below. (a separate form is required for each patient) How do I fill this out? In Florida, a medical power of attorney form ensures that someone you trust can make medical decisions on your behalf if you're unable to do so. A separate form is required for each patient. A medical power of attorney form in Florida grants legal authority to a chosen individual to make healthcare decisions when the principal cannot. If available, fill in the patient's group identification number. 3. Ordering Physician or Clinic Information.