Revocation of Statutory Living Will - Louisiana 2026

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The document outlines the process for revoking a Living Will in accordance with Louisiana Revised Statutes 40:1299.58.4. It specifies that a declarant can revoke their Living Will through various methods, including physical destruction of the document, a written statement of revocation, or an oral expression of intent to revoke. The document serves as a formal written revocation and includes spaces for the declarant's signature, printed name, and address.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in your name as the Declarant at the top of the form. This identifies you as the individual revoking the Living Will.
Next, enter the date on which you originally executed your Declaration (Living Will) in the designated field.
In the section outlining methods of revocation, ensure you understand that this document serves as your written revocation. You may want to include a statement expressing your intent clearly.
Fill in the date and sign at the bottom of the form. Your signature is crucial for validating this revocation.
Lastly, provide your printed name and address to complete your identification on this document.

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