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Fill and Sign the Bills Would Amend State Do Not Resuscitate Lawsmichigan Form

Fill and Sign the Bills Would Amend State Do Not Resuscitate Lawsmichigan Form

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REVOCATION OF DO-NOT-RESUSCITATE ORDER I, , Declarant, executed a DO-NOT- RESUSCITATE ORDER day of , 20 , regarding my decisions and choices in the event my heart and breathing should stop. Pursuant to Michigan Consolidated Statutes, 333.1060, which provides that a DO-NOT-RESUSCITATE ORDER may be revoked at any and in any manner by which I am able to communicate an intent to revoke the order. This is my written revocation of my DO-NOT-RESUSCITATE ORDER and is provided to all persons to whom I have provided a copy of my DO-NOT-RESUSCITATE ORDER.DATED this the day of , 20 . Signature of Declarant: __________________________________________________________Printed Name of Declarant: Address of Declarant:

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