This Revocation of Anatomical Gift Donation form is a revocation of Form WI-P025 that designates the body parts and organs an individual wishes to donate at the time of death. A donor may amend or revoke an anatomical gift or a refusal to make an anatomical gift by signing a statement of amendment or revocation, by signing a new document of gift, by verbally amending or revoking in the presence of 2 individuals, by, during the donor's terminal illness or injury making, any form of communication that is addressed to a physician, by delivering a signed statement of amendment or revocation to a specified donee to whom a document of gift had been delivered, by crossing out or amending the donor authorization or refusal in the space provided on his or her license or identification card or by revoking the provision of a power of attorney for health care instrument that makes an anatomical gift or revoking that power of attorney for health care instrument. Specific reference is made to the earlier executed Anatomical Gift Donation.
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.