Utah Revocation of Declaration for Mental Health Treatment
What is this form?
The Revocation of Declaration for Mental Health Treatment form is a legal document that allows an individual (the Declarant) to revoke their authority granted in a prior declaration regarding mental health treatment. This form is specifically designed for those who wish to withdraw consent for decisions about psychoactive medication, convulsive therapy, and short-term admission to a mental health facility. Unlike similar forms, this document serves as a clear directive that rescinds any prior mental health treatment declarations made by the Declarant.
Key parts of this document
- Declarant's name and identification details.
- Date of execution of the original Declaration for Mental Health Treatment.
- Explicit statement of revocation of the prior declaration.
- Signature of the Declarant to verify the revocation.
- Date of revocation to indicate the moment the change takes effect.
- Address of the Declarant for identification purposes.
When to use this document
This form should be used when an individual who previously issued a Declaration for Mental Health Treatment (Form UT-P017) decides to revoke their authority over mental health decisions. This may occur when the individual regains clarity of mind, wishes to appoint a different person as their attorney-in-fact, or simply no longer wishes to have that authority granted. It is essential to ensure that such revocation is documented and communicated to all relevant parties.
Intended users of this form
- Individuals who have previously completed a Declaration for Mental Health Treatment.
- Persons wishing to revoke their consent for mental health treatment directives.
- Those seeking to clarify their mental health treatment preferences.
- Individuals capable of making informed decisions regarding their mental health.
Completing this form step by step
- Write your name as the Declarant at the top of the form.
- Enter the date on which you executed the original Declaration for Mental Health Treatment.
- Clearly state that you are revoking the previous declaration.
- Sign and date the form to validate the revocation.
- Provide your address for identification purposes and to ensure communication.
Does this document require notarization?
This form does not typically require notarization unless specified by local law. It is advisable to check local regulations for any additional requirements.
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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
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.
Mistakes to watch out for
- Failing to indicate the date of the original declaration.
- Not providing a valid signature or date on the revocation form.
- Overlooking the need to inform concerned parties about the revocation.
Benefits of using this form online
- Easy access to download and edit your legal documents.
- Convenient completion from anywhere at any time.
- Reliable templates drafted by licensed attorneys to ensure legal soundness.
- The Revocation of Declaration for Mental Health Treatment allows you to revoke previous mental health treatment decisions.
- Ensure all necessary information is completed accurately to avoid invalidation of the form.
- This form is an essential tool for asserting control over your mental health treatment preferences.
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FAQ
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.
A principal can rescind a Power of Attorney at any time, even if the Power of Attorney has a specified end date, so long as the principal is competent and the attorney-in-fact is notified. Third parties (such as a bank or the Land Titles Office) should also be notified of the revocation.
The best way to revoke a Durable Power of Attorney for Health Care and Living will is to make a written statement revoking the document and give it to everyone who has a copy of your Durable Power of Attorney for Health Care and Living Will.
In other words, a Revocation of Power of Attorney is written confirmation that a principal (the person who appointed power in a Power of Attorney) no longer wants or needs their attorney-in-fact (the person who was appointed power in a Power of Attorney, sometimes called an agent or donor) to act on their behalf.
"In case you forget to mention when and under what circumstances your power of attorney can be revoked, and if the power of attorney does not state it is irrevocable, then the power of attorney can be revoked if you execute a document cancelling it.
