Hospital Visitation Authorization

This form lets a person name a

The court describes it as: Use this form to designate a person (e.g., same-sex partner) as a support person and an allowed hospital visitor.

Common questions

What is this form for?

This form is used to name a support person and list allowed visitors for a person in a hospital or medical facility.

Does this form deal with court cases?

The form mentions support person rules from Medicare and Medicaid, but it is not a court filing form.

Revision history

No changes recorded since we started tracking this form on October 9, 2026.

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