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Fill and Sign the Revocation of Medical Durable Power of Attorney Colorado Form

Fill and Sign the Revocation of Medical Durable Power of Attorney Colorado Form

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REVOCATION OF MEDICAL DURABLE POWER OF ATTORNEY (Colorado Revised Statutes 15-14-506) I,       , Declarant, having executed a Medical Durable Power of Attorney on the       day of       , 20       . Colorado Revised Statutes 15-14-506 provides that I have the right to revoke the authority granted to my agent by informing him or her or my health care provider orally or in writing. This is my written revocation of the above referenced Power of Attorney and I am providing a copy of this revocation to all parties to whom I provided a copy of the original instrument. DATED this the       day of       , 20       . Signature of Declarant: __________________________________________________________ Printed Name of Declarant:       Address of Declarant:      

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Revoke power of attorney Colorado
Colorado Revised Statute 15 14.503 509

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