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Nebraska Revocación de poder notarial para atención médica

Revocación del Poder Notarial para el Cuidado de la Salud - Nebraska Revocation of Power of Attorney for Health Care

Category:

Poder notarial - Atención médica - Revocaciones - Alaska

State:

Nebraska

Control #:

NE-P014B

Format:

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Description

This Revocation of Statutory Power of Attorney for Health Care form is a revocation of the authority and power granted in Form NE-P014, which gives the person you designate as your agent/attorney in fact the power to make health care decisions for you. You may revoke a power of attorney for health care at any time while you are competent and in any manner (such as through this form) by which you communicate your intent to revoke.

Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.

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How to fill out Nebraska Revocación De Poder Notarial Para Atención Médica?

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Revocación de poder notarial para atención médica

Power of Attorney and Health Care - General - Nebraska

Contents

A power of attorney for health care must:

be in writing;

identify the principal, the attorney in fact, and the successor attorney in fact (if any);

specifically authorize the attorney in fact to make health care decisions on behalf of the principal in the event the principal is incapable;

show the date of its execution; and

be witnessed and signed by at least two adults. Each witness must either witness the signing and dating by the principal or the principal's acknowledgment of the signature and date. In the alternative, the power of attorney may be signed and acknowledged by the principal before a notary public who may not be the attorney in fact or the successor attorney in fact.

Witnesses

The following cannot be witnesses: the principal's spouse, parent, child, grandchild, sibling, presumptive heir, known devisee at the time of the witnessing, attending physician, or attorney in fact, or an employee of a life or health insurance provider for the principal. No more than one witness may be an administrator or employee of a health care provider who is caring for or treating the principal.

Each witness must make the written declaration in substantially the form prescribed in § 30-3408.

Attorney in Fact

None of the following may serve as an attorney in fact:

The attending physician;
An employee of the attending physician who is unrelated to the principal by blood, marriage, or adoption;
A person unrelated to the principal by blood, marriage, or adoption who is an owner, operator, or employee of a health care provider in or of which the principal is a patient or resident; or
A person unrelated to the principal by blood, marriage, or adoption if, at the time of the proposed designation, he or she is presently serving as an attorney in fact for ten or more principals.

Withdrawal of Attorney in Fact

When a principal is not incapable, the attorney in fact may withdraw by giving notice to the principal. When a principal is incapable, the attorney in fact may withdraw by giving notice to the health care provider. The withdrawal of an attorney in fact must be made a part of the principal's medical records.

Form

A power of attorney for health care executed on or after September 9, 1993, shall be in a form which complies with sections 30-3401 to 30-3432 and may be in the form provided by statute.

A power of attorney for health care may be included in a durable power of attorney drafted under the Uniform Durable Power of Attorney Act or in any other form if the power of attorney for health care included in such durable power of attorney or any other form fully complies with the terms of § 30-3404.

Duration

A power of attorney for health care continues in effect until the principal's death, until revoked, or until the attorney in fact and any successor attorney in fact withdraws.

Revocation

A power of attorney for health care may be revoked at any time by a principal who is competent and in any manner by which the principal is able to communicate his or her intent to revoke. Revocation is effective upon communication to the attending physician, the health care provider who shall promptly inform the attending physician of the revocation, or the attorney in fact who shall promptly inform the attending physician of the revocation.

The creation by the principal of written wishes or instructions about health care or limitations upon the attorney in fact's authority shall not revoke a power of attorney for health care unless such wishes, instructions, or limitations expressly provide otherwise.

Unless the power of attorney for health care provides otherwise, execution of a valid power of attorney for health care shall revoke any previously executed power of attorney for health care.

Unless the power of attorney for health care provides otherwise, a power of attorney for health care supersedes:

Any conflicting pre-existing directive;
Any guardianship proceedings under the Nebraska Probate Code to the extent the proceedings involve the right to make health care decisions for the protected person; and
Any conservatorship proceedings under the Nebraska Probate Code to the extent the proceedings involve the right to make health care decisions for the protected person.

A decree of divorce or legal separation entered into pursuant to §§ 42-347 to 42-380 may specify whether the choice of the principal's spouse as attorney in fact under a power of attorney for health care shall be revoked or remain effective. If the decree does not specify whether the choice of the spouse as the principal's attorney in fact for health care is revoked or remains effective, the choice of the principal's spouse as attorney in fact for health care shall be deemed revoked upon entry of the decree.

The revocation of a power of attorney for health care shall not revoke or terminate the authority as to the attorney in fact or other person who acts in good faith under the power of attorney for health care and without actual knowledge of the revocation. An action taken without knowledge of the revocation, unless the action is otherwise invalid or unenforceable, shall bind the principal and his or her heirs, devisees, and personal representatives.

Revocación de poder notarial para atención médica

Power of Attorney and Health Care - General - Nebraska

Contents

A power of attorney for health care must:

be in writing;

identify the principal, the attorney in fact, and the successor attorney in fact (if any);

specifically authorize the attorney in fact to make health care decisions on behalf of the principal in the event the principal is incapable;

show the date of its execution; and

Witnesses

Each witness must make the written declaration in substantially the form prescribed in § 30-3408.

Attorney in Fact

None of the following may serve as an attorney in fact:

Withdrawal of Attorney in Fact

Form

A power of attorney for health care executed on or after September 9, 1993, shall be in a form which complies with sections 30-3401 to 30-3432 and may be in the form provided by statute.

Duration

A power of attorney for health care continues in effect until the principal's death, until revoked, or until the attorney in fact and any successor attorney in fact withdraws.

Revocation

Unless the power of attorney for health care provides otherwise, execution of a valid power of attorney for health care shall revoke any previously executed power of attorney for health care.

Unless the power of attorney for health care provides otherwise, a power of attorney for health care supersedes:

Revocación del Poder Notarial para el Cuidado de la Salud - Nebraska Revocation of Power of Attorney for Health Care

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Revocación del Poder Notarial para el Cuidado de la Salud - Nebraska Revocation of Power of Attorney for Health Care

This form is part of a form package!

Description

Related forms

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How to fill out Nebraska Revocación De Poder Notarial Para Atención Médica?

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