Revocation of Health Care Directive - Arizona

Arizona · Fillable PDF · Free

Use this form to cancel all or part of a health care power of attorney, living will or mental health care power of attorney. A written, notarized revocation leaves a clear record for hospitals and family. Use this form to cancel all or part of a health care power of attorney, living will or mental health care power of attorney.

Serving Arizona. Appointments require an Arizona-commissioned notary.

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Who this form is for

• Use this form to cancel all or part of a health care power of attorney, living will or mental health care power of attorney. A written, notarized revocation leaves a clear record for hospitals and family.

What you'll need

• The original Revocation of Health Care Directive - Arizona packet and its instructions.
• Names, dates and supporting records identified in this packet.
• Acceptable identification for any notarial act; arrange qualified witnesses when required.

How to complete it

1. Check what you are revoking List each document and its date.
2. List who gets a copy Your doctors, hospital, former agent and family.
3. Sign before a notary Bring a current photo ID.
4. Update the registry If you filed with the Arizona Health Care Directives Registry, ask to remove or replace it.

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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