California Revocation Health Care Directive

This is a revocation of the authority granted in Form CA-P021, a Health Care Directive. A Health Care Directive is used to name an individual as an agent to make health care decisions for you if you become incapable of making your own decisions or if you want someone else to make those decisions for you even though you are still capable; to give specific instructions about any aspect of your health care, whether or not you appoint an agent; to express an intention to donate your bodily organs and tissues following your death; and/or to designate a physician to have primary responsibility for your health care. A patient having capacity may revoke the designation of an agent only by a signed writing or by personally informing the supervising health care provider. A patient having capacity may revoke all or part of an advance health care directive, other than the designation of an agent, at any time and in any manner that communicates an intent to revoke.