The Revocation of Durable Power of Attorney for Health Care is a legal document that cancels the authority granted to an agent to make health care decisions on your behalf. This form is essential if you wish to withdraw any previously assigned power to someone to manage your medical choices, ensuring that your health care preferences are respected.
You should use this form when you want to revoke a previously signed Durable Power of Attorney for Health Care. This may occur if you no longer wish for your designated agent to make health care decisions, if the agent is no longer suitable, or if you wish to appoint a new agent entirely. This form helps ensure that your current wishes regarding medical decisions are clearly documented and legally recognized.
This form is intended for any individual who has previously appointed an agent under a Durable Power of Attorney for Health Care and wishes to revoke that authority. It is suitable for:
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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
A medical power of attorney is a legal document that names one person the health care agent of another person. The agent has the ability to make health care decisions and the responsibility to make sure doctors and other medical personnel provide necessary and appropriate care according to the patient's wishes.
A power of attorney (POA) is a legal document that allows you to appoint someone to act on your behalf, usually in financial or medical situations.An agent can never transfer their authority to another person unless the POA explicitly permits it.
You can revoke a Medical Power of Attorney even if you cannot make your own medical decisions. To cancel it, you can: Tell the agent, in person or in writing,Sign a new Medical Power of Attorney.
A principal can revoke the power of attorney while he or she is still mentally competent. A principal can complete a formal written document requesting the revocation of a power of attorney at any time, for any reason, while he or she is still competent. The principal must sign and notarize the revocation request.
The Durable Power of Attorney for Health Care authorizes someone to make decisions about your health care.You can have both a Durable Power of Attorney for Health Care and a Financial or General Power of Attorney, and you can name a different agent for the purposes of each document.
In California and in many other states, there are POA forms specific to healthcare, and medical decisions are excluded from the general durable POAs. This means you can designate one person to be your agent for health decisions, and another for financial or legal decisions.
Unless the power of attorney states otherwise, and they usually don't, a revocation of a POA must be made in writing. A verbal revocation may not be enough.A revocation will reference the existing POA and the current attorney-in-fact and revoke the document and the powers granted.
Until an attorney-in-fact's powers are properly revoked, they can continue to legally act for the principal. To cancel a Power of Attorney, the principal can create a document called a Revocation of Power of Attorney or create a new Power of Attorney that indicates the previous Power of Attorney is revoked.
In California and in many other states, there are POA forms specific to healthcare, and medical decisions are excluded from the general durable POAs. This means you can designate one person to be your agent for health decisions, and another for financial or legal decisions.