Wisconsin Advance Directive Form

Overview: In Wisconsin you must fill out two separate forms to have a complete Advance Directive: A Living Will called a "Directive to Physicians and Family or Surrogates" and a "Power of Attorney for Health Care" (a.k.a. Health Care Proxy).

Required Information for the Living Will: You and two (2) witnesses must sign your WI Living Will for it to be considered valid. Witnesses MUST be at least 18 years of age. Witnesses CAN NOT be:

• Related to you by blood, marriage or adoption
• Directly financially responsible for your health care
• Persons who know they are entitled to or have a claim on any portion of your estate
• A health care provider who is serving you at the time the document is signed, an employee of the health care provider, other than a chaplain or a social worker, or an employee other than a chaplain or social worker of an inpatient health care facility in which you are a patient

Download the Wisconsin Living Will Form Here

Required Information for Naming a Health Care Proxy: You and two (2) witnesses must sign your WI Health Care Proxy form for it to be considered valid. Witnesses MUST be at least 18 years of age. Witnesses CAN NOT be:

• Related to you by blood, marriage or adoption
• Directly financially responsible for your health care
• Persons who know they are entitled to or have a claim on any portion of your estate
• A health care provider who is serving you at the time the document is signed, an employee of the health care provider, other than a chaplain or a social worker, or an employee other than a chaplain or social worker of an inpatient health care facility in which you are a patient

Download the Wisconsin Health Care Proxy Form Here
(Via Wisconsin Department of Health Services)

Remember to add your completed form to your Everplan!

See our complete list of resources for Wisconsin.