Revocation of Advance Health Care Directive - California

California · Fillable PDF · Free

Identify an earlier health care directive or agent appointment you want to revoke. The packet includes instructions and a distribution record for notifying others. You want to cancel a health care directive, remove an agent or revoke part of your instructions.

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Who this form is for

• People reviewing an earlier health care directive.
• Someone changing a health care agent or part of their instructions.
• Families keeping a record of who receives a revocation.

What you'll need

• Your identifying information and the earlier directive's signing date.
• Names of agents and any relevant registry information.
• A distribution list, completed document and acceptable photo ID for notarization.

How to complete it

1. Read the packet and identify the earlier health care directive.
2. Review the choices for revoking all or part of the directive with an attorney if needed.
3. Arrange your signing appointment and follow the packet's signature instructions.
4. Use the distribution record to track copies given to agents, providers and facilities.

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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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