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Revocation Of Advance Health Care Directive (Alabama) POA-AL 102 - Legal Forms
| Revocation Of Advance Health Care Directive (Alabama) Form. This is a Legal Forms form and can be used in Health Care-Living Wills Power Of Attorney . |
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ALABAMA-REVOCATION OF ADVANCE HEALTH CARE DIRECTIVE (Alabama Code - Section 22-8A-5) (Revocation of advance directive for health care) Pursuant to Section 22-8A-5, an advance directive for health care may be revoked at any time by the declarant by any of the following methods: (1) By being obliterated, burnt, torn, or otherwise destroyed or defaced in a manner indicating intention to cancel; (2) By a written revocation of the advance directive for health care signed and dated by the declarant or person acting at the direction of the declarant; or (3) By a verbal expression of the intent to revoke the advance directive for health care in the presence of a witness 19 years of age or older, who signs and dates a writing confirming that such expression of intent was made. Any verbal revocation shall become effective upon receipt by the attending physician or health care provider of the above mentioned writing. The attending physician or health care provider shall record in the patient's medical record the time, date and place of when he or she received notification of the revocation. I, _________________________________________________________ , Declarant, having executed a Advance Health Care Directive regarding certain choices and decisions that I had made relating to my healthcare to my agent who was empowered to make health care decisions on behalf of me, the principal on the day of 20 . Revocation: I hereby revoke my healthcare directive dated of 20 , in the form of written revocation which was signed and dated by me, the declarant or any person acting at the direction of the declarant. I am providing a copy of this revocation to all parties to whom I provided a copy of the original directive. DATED this the day of , 20 . Signature of Declarant: Printed Name of Declarant: Address of Declarant: American LegalNet, Inc. © www.FormsWorkFlow.com
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