Health Care Proxy Form - New York
Frequently Asked Questions, continued
deposit box. Bring a copy if you are admitted to the
hospital, even for minor surgery, or if you undergo
May I use the Health Care Proxy form to
express my wishes about organ and/or
Yes. Use the optional organ and tissue donation
section on the Health Care Proxy form and be sure
to have the section witnessed by two people. You
may specify that your organs and/or tissues be
used for transplantation, research or educational
purposes. Any limitation(s) associated with your
wishes should be noted in this section of the proxy.
Failure to include your wishes and instructions
on your Health Care Proxy form will not be taken
to mean that you do not want to be an organ and/
or tissue donor.
Can my health care agent make decisions
for me about organ and/or tissue donation?
Yes. As of August 26, 2009, your health care agent
is authorized to make decisions after your death,
but only those regarding organ and/or tissue
donation. Your health care agent must make
such decisions as noted on your Health Care
Who can consent to a donation if I choose
not to state my wishes at this time?
It is important to note your wishes about organ
and/or tissue donation to your health care agent,
the person designated as your decedent’s agent, if
one has been appointed, and your family members.
New York Law provides a list of individuals who
are authorized to consent to organ and/or tissue
donation on your behalf. They are listed in order
of priority: your health care agent; your decedent’s
agent; your spouse, if you are not legally separated,
or your domestic partner; a son or daughter 18
years of age or older; either of your parents; a
brother or sister 18 years of age or older; or a
guardian appointed by a court prior to the
Health Care Proxy Form - New York PDF
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