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Fill and Sign the Revocation of Health Care Proxy Florida Form

Fill and Sign the Revocation of Health Care Proxy Florida Form

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REVOCATION OF DESIGNATION OF HEALTH CARE SURROGATE I,       , Declarant, having executed a Designation of Health Care Surrogate on the       day of       , 20       . Florida Statutes 765-203 provides that this an advance directive or designation of a surrogate may be amended or revoked at any time by a competent principal: (a) By means of a signed, dated writing; (b) By means of the physical cancellation or destruction of the advance directive by the principal or by another in the principal's presence and at the principal's direction; (c) By means of an oral expression of intent to amend or revoke; or (d) By means of a subsequently executed advance directive that is materially different from a previously executed advance directive. This is my written revocation of the above referenced Designation of Health Care Surrogate and I am providing a copy of this revocation to all parties to whom I provided a copy of the original Designation. DATED this the     day of       , 20       . _____________________________________ ___________________________________________ Witness Declarant Print Name:       _____________________________________ Witness Print Name:       Printed Name of Declarant:       Address of Declarant:      

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Health care proxy Florida pdf
Florida health care proxy statute
765.202 Florida Statutes
Part V of chapter 765, Florida Statutes
Who makes medical decisions if you are incapacitated in Florida
according to fl statute 765.202 the designation of a health care surrogate must be signNowd.
Medical proxy form Florida
Florida health care surrogate form 2024

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