Revocations of Power of Attorney for Heath Care are necessary in order to revoke those powers previously given to another in regard to decisions about your health care. It will make the original Power of Attorney document null and void.
Revocation of a Power of Attorney for Health Care
I, __________, of __________, by written instrument dated __________, 20____, appointed __________ of __________, my attorney in fact for the purposes and with powers therein set forth under my Power of Attorney for Health Care
Notice is hereby given that I have revoked, and do hereby revoke, the above-described power of attorney, and all power and authority thereby given, or intended to be given, to ______________.
Dated: __________, 20____.
STATE OF ____________ §
COUNTY OF __________ §
______________________, personally appeared before me this _____ day of ____________, 200___.
My commission expires: ___________________