This Revocation of Statutory Power of Attorney for Health Care form is a revocation of the authority and power granted in Form WI-P014 that gives the person you designate as your agent/attorney in fact the power to make health care decisions for you. You may revoke your power of attorney for health care at any time by canceling, defacing, obliterating, burning, tearing or otherwise destroying the power of attorney for health care instrument or directing another person in your presence to destroy the power of attorney for health care instrument, by executing a statement, signed, dated, and in writing, expressing your intent to revoke the power of attorney for health care, by verbally expressing, in the presence of two witnesses, your intent to revoke the power of attorney for health care, or by executing a subsequent power of attorney for health care instrument.
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.