Revocation of Advance Directive for Health Care - Georgia
Georgia · Fillable PDF · Free
Use this form to cancel all or part of a Georgia Advance Directive for Health Care, or an older Georgia living will or durable power of attorney for health care. A signed, notarized revocation is clear written proof for hospitals, doctors and your former agent. If you want new instructions, sign a new Georgia Advance Directive for Health Care, which automatically replaces earlier ones. Use this form to cancel all or part of a Georgia Advance Directive for Health Care, or an older Georgia living will or durable power of attorney for health care.
Georgia residents and families reviewing revocation of advance directive for health care.
What you'll need
Read the packet’s instructions before completing its fields.
Follow the packet’s signing, witness and identification instructions.
How to complete it
Identify yourself Enter your full legal name, date of birth and address.
Check what you are revoking Check the whole directive, only the agent appointment, older documents, or everything signed before today. Fill in the dates.
List who to notify — optional Record your former agent and the doctors and facilities that have a copy.
Sign before a notary Do not sign ahead of time. Bring a current government-issued photo ID. Our mobile notary can come to your home, hospital or care facility.
This is Georgia’s official form for naming a health care agent and writing down your treatment wishes. It replaces the old Georgia living will and durable power of attorney for health care. It does not cover finances — for that, use a Georgia Statutory Form Power of Attorney. You may fill out any of Parts One to Three, but you must complete Part Four.
This notarized affidavit lets you choose who will make your funeral, burial or cremation decisions, and record your wishes. Without one, Georgia law gives that right to family in a fixed order, starting with a spouse, which can lead to disputes. A health care agent named in your Georgia Advance Directive still comes first, so make sure the two documents agree.
This form lets doctors, hospitals and insurers share your medical information with a family member, agent, attorney or anyone else you choose. It is often signed alongside a power of attorney or advance directive so your agent can get records quickly. Many providers, insurers and attorneys prefer a notarized authorization because it proves the signature is yours.
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.