Wisconsin Advance Directive Form (Medical POA + Living Will)

A Wisconsin advance directive is a set of documents that allow patients to describe end-of-life wishes and treatments they would accept or refuse if they were to become incapacitated. The patient may elect a health care power of attorney who may further guide medical staff in the interest of the patient. Directives are employed when the patient can no longer make their own decisions.

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What’s Included?


Signing Requirements (§ 244.05§ 154.03(1)) – Two (2) witnesses.

 State Definitions

  • Declaration (WI Stat § 154.02(1)) – “Declaration” means a written, witnessed document voluntarily executed by the declarant under s. 154.03 (1), but is not limited in form or substance to that provided in s. 154.03 (2).
  • Power of Attorney for Health Care (WI Stat § 155.01(10)) – Power of attorney for health care” means the designation, by an individual, of another as his or her health care agent for the purpose of making health care decisions on his or her behalf if the individual cannot, due to incapacity.

Versions (4)


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Department of Health Services

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blankGroup Health Cooperative of South Central Wisconsin

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