Revocation of Health Care Directive - North Carolina

Download Revocation of Health Care Directive - North Carolina PDF

North Carolina · Fillable PDF · Free

Use this form to cancel a North Carolina health care directive, a durable power of attorney for health care, or a mental health advance directive. Use this form to cancel a North Carolina health care directive, a durable power of attorney for health care, or a mental health advance directive.

Serving North Carolina. Our mobile notaries serving North Carolina are commissioned in North Carolina and travel to your home, office, hospital, or other convenient location.

Book a notary for Revocation of Health Care Directive - North Carolina

Using this document abroad?

You may need an apostille. We can help.

Check our apostille service pricing, see the destination countries we assist with, and learn how to get started.

View Apostille Pricing & Countries

Who this form is for

• Use this form to cancel a North Carolina health care directive, a durable power of attorney for health care, or a mental health advance directive.

What you'll need

• Read the packet and check the receiving agency's required form.
• Gather the names, dates and supporting records requested in the document.
• Review the packet's signing, identification and witness instructions.

How to complete it

1. Identify the documents (Page 1) Check each document you are revoking and enter its date and agent names.
2. Sign before a notary (Page 2) Under North Carolina law, you may revoke these documents at any time while competent, in writing or by clearly communicating your intent to your agent, doctor, or health care provider. A notarized revocation gives clear proof of the date and your identity. Bring a current, government-issued photo ID.
3. Notify your doctors and agents (Page 2) Give copies to your doctor, hospital, and each agent named, and record each notice.
4. Ask them to destroy or return their copies of the revoked documents.
5. To give new instructions, sign a new North Carolina Health Care Power of Attorney or Living Will. We have free forms. If the original was filed with the Secretary of State’s registry, file the revocation too.

Related North Carolina forms

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.

Free legal forms by state · Book a mobile notary