This is a revocation of Form WY-P021, a Psychiatric Advance Directive, which allows you to express your wishes regarding whether or not psychiatric restabilization measures are to be used in your treatment. This form complies with all state statutory laws, (Wyoming Statute 35-22-307) and requires only the signature of the individual who is revoking the directive. Psychiatric advance directives may be revoked at any time by the person who is the subject of the directive unless he is mentally incompetent and by a person who is authorized to consent to or refuse psychiatric restabilization measures on behalf of the person who is the subject of the directive.
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.