Homepage Fillable Living Will Document for Wisconsin
Content Overview

In the kaleidoscopic landscape of legal documents that cater to end-of-life planning, the Wisconsin Living Will form emerges as an indispensable tool for those seeking to articulate their healthcare preferences in the event they can no longer communicate these themselves. This pivotal document, set against the backdrop of Wisconsin's nuanced legal code, empowers individuals to preemptively outline their wishes concerning life-sustaining treatment, including decisions on the use of ventilators, feeding tubes, and other forms of life support, under specific health conditions. Not merely a form but a beacon of autonomy, it provides a voice to the voiceless at potentially the most critical junctures of their lives. Tailored to meet the specific legislative requirements of Wisconsin, it ensures that the individual's healthcare directives are both respected and legally acknowledged. Importantly, the nature of this document demands thoughtful consideration and, oftentimes, consultation with healthcare professionals and legal advisors to ensure that one's desires are clearly articulated and executable under Wisconsin law. As such, the Wisconsin Living Will form stands not just as a document, but as a profound statement of personal dignity and self-determination.

Preview - Wisconsin Living Will Form

Wisconsin Living Will Template

This Living Will is designed to be in compliance with the Wisconsin Statutes, specifically the Wisconsin Declarations to Physicians (Wisconsin Living Will) Law. Its purpose is to direct medical professionals regarding your care should you become incapacitated and unable to communicate your healthcare wishes.

Personal Information

Full Name: _________________________________________

Address: ____________________________________________

City, State, Zip: ___________________________________

Date of Birth: ______________________________________

Social Security Number: _____________________________

Healthcare Directives

In the event that I, __________________________________ (insert full name), become incapacitated and am unable to communicate my healthcare wishes, I direct the following actions be taken regarding my care. My directives are as follows:

  1. If I am in a terminal condition, as defined by Wisconsin law, where the application of life-sustaining measures would only serve to artificially prolong the dying process, I direct that such measures be withheld or withdrawn, and that I be permitted to die naturally.
  2. If I am in a persistent vegetative state or in a condition of permanent unconsciousness, and there is no reasonable expectation of recovering a significant cognitive function, I direct that life-sustaining measures, including artificial nutrition and hydration, be withheld or withdrawn.

Additional Instructions

You may add any specific wishes or instructions regarding your healthcare that are not covered above:

____________________________________________________________________________________

____________________________________________________________________________________

Designation of Healthcare Agent

If you wish to appoint a Health Care Agent to make healthcare decisions for you, should you become unable to make them yourself, complete the following:

Health Care Agent's Full Name: _______________________________________________

Relationship to You: ________________________________________________________

Address: ____________________________________________________________________

Primary Phone: __________________________ Alternate Phone:: _________________________

Signature

This document reflects my wishes and I understand its contents. It is executed voluntarily and without any undue influence.

Date: _____________________ Signature: __________________________________

Witness #1

Name: ________________________________________

Signature: ___________________________________

Date: ________________________________________

Witness #2

Name: ________________________________________

Signature: ___________________________________

Date: ________________________________________

File Details

Detailed Instructions for Using Wisconsin Living Will

In Wisconsin, completing a Living Will is an essential step for those who wish to document their healthcare preferences in the event they become unable to communicate their decisions due to a severe medical condition. By filling out a Living Will, individuals have the opportunity to provide specific instructions regarding the use of life-sustaining measures. This process involves thoughtful consideration and a few key steps to ensure the document reflects your wishes accurately and is legally valid.

  1. Begin by obtaining the most recent version of the Wisconsin Living Will form from a reliable source, ensuring it complies with state laws.
  2. Read the entire form carefully before you start filling it out to familiarize yourself with the content and the type of decisions you will need to make.
  3. Enter your full legal name and date of birth at the top of the form to clearly identify yourself as the principal — the person creating the Living Will.
  4. Review the sections that allow you to choose the circumstances under which you want to either receive or not receive life-sustaining treatment and any other specific medical interventions. Make your selections according to your personal beliefs and health care preferences.
  5. If you have specific wishes that are not covered by the form's standard options, use the space provided to detail any additional instructions. This could include preferences regarding pain management, artificial nutrition, and hydration, or other treatments.
  6. Select a trusted individual to act as your health care agent, who will have the authority to make health care decisions on your behalf if you’re unable to communicate your wishes. Include their full name, relationship to you, and contact information.
  7. After reviewing all sections and confirming your choices, sign and date the form in the presence of two qualified witnesses or a notary public. Wisconsin law has specific requirements about who can serve as a witness, so be sure to follow these closely to ensure your Living Will is legally binding.
  8. Once completed, make copies of the signed document. Give one to your health care agent, one to your primary care physician, and keep one for yourself in a safe but accessible place. Consider also giving copies to close family members or other doctors who are involved in your care.

Completing a Living Will is a proactive step towards ensuring your health care preferences are respected, even when you may not be able to voice them yourself. It’s an important document that requires careful consideration, but the peace of mind it provides can be invaluable to both you and your loved ones.

Listed Questions and Answers

What is a Living Will and how is it used in Wisconsin?

A Living Will, formally recognized in Wisconsin as a "Declaration to Physicians," is a legal document that allows an individual to outline their preferences regarding life-sustaining medical treatment in the event they become incapacitated and are diagnosed with a terminal condition or are in a persistent vegetative state. This document communicates to healthcare providers and loved ones what medical actions should be taken or withheld when the person is no longer able to make decisions for themselves.

Who can create a Living Will in Wisconsin, and what are the requirements?

In Wisconsin, any competent individual who is 18 years of age or older, or a minor who has been emancipated, can create a Living Will. The document must be voluntarily signed by the creator in the presence of two witnesses. These witnesses must be adults and cannot be the individual's healthcare provider, an employee of the healthcare provider, a spouse, or a relative by blood, marriage, or adoption. The creation of a Living Will does not require notarization in Wisconsin.

How can a Wisconsin Living Will be revoked?

An individual may revoke their Living Will at any time, regardless of their mental state. Revocation can be accomplished in several ways: by destroying the document, by creating a new Living Will, by expressing the intent to revoke it through a written statement, or by orally stating the revocation in the presence of two witnesses. It is crucial to inform healthcare providers of the revocation to ensure the changes are acknowledged and reflected in the individual's medical records.

When does a Wisconsin Living Will become effective?

A Living Will becomes effective in Wisconsin when the document has been provided to the individual's attending physician, and the individual is determined by two physicians to be either in a terminal condition or in a persistent vegetative state, and unable to communicate their health care decisions. It is advisable to discuss your Living Will with your physician in advance and to provide copies to trusted family members or friends.

Is a Living Will different from a Power of Attorney for Health Care in Wisconsin?

Yes, a Living Will and a Power of Attorney for Health Care are two distinct legal documents in Wisconsin. While a Living Will specifies an individual’s wishes regarding life-sustaining treatment when they are incapacitated, a Power of Attorney for Health Care appoint our someone to make healthcare decisions on their behalf. These decisions can cover a wide range of treatments and are not limited to life-sustaining measures. Both documents are integral parts of advance care planning and can complement each other, but they serve different purposes.

Common mistakes

Filling out a Wisconsin Living Will form involves important decisions about one's healthcare preferences in the event they are no longer able to make decisions for themselves. Here are seven mistakes commonly made during this process:

  1. Not clearly specifying medical conditions for which the living will applies. Many people mistakenly believe that a living will is universally applicable, failing to understand that it only comes into effect under specific circumstances, such as terminal illness or permanent unconsciousness.
  2. Failing to update the document. People often overlook the importance of updating their living will to reflect their current health status, advances in medical technology, and changes in their personal beliefs and preferences.
  3. Inadequate discussion with healthcare providers. A significant mistake is not having detailed conversations with healthcare providers about the implications of choices made within the form. This lack of dialogue can lead to misunderstandings about the individual's desires for end-of-life care.
  4. Omitting a durable power of attorney for healthcare. While this is a separate document, not designating someone to make healthcare decisions when one is incapacitated can complicate the effectiveness of the living will.
  5. Not being specific enough about treatments. Many people make the error of not being explicit about which treatments they want to refuse or accept. Without specificity, healthcare providers might be left to interpret general statements, potentially leading to actions contrary to the person's actual wishes.
  6. Overlooking the need for witnesses or a notary. Wisconsin law requires living wills to be either witnessed by two individuals or notarized. Forgetting this step can invalidate the entire document.
  7. Keeping the document inaccessible. A critically overlooked mistake is failing to ensure the living will is accessible when needed. This document should be shared with one's healthcare proxy, primary care doctor, and potentially included in a registry if the state offers one.

Many people approach the preparation of a Wisconsin Living Will form with good intentions but often fall short in fully safeguarding their healthcare preferences due to these common mistakes. To avoid these pitfalls, it is advisable to:

  • Engage in regular discussions with healthcare providers and ensure they have a copy of the document.
  • Review and update the living will periodically, especially after major life events or changes in health status.
  • Clearly communicate specific medical treatments one desires or wants to avoid in certain situations.
  • Ensure the document is properly executed with the required legal formalities, such as witness or notary signatures.
  • Inform family members, healthcare proxies, and anyone else involved in one's healthcare about the location and contents of the living will.

By being mindful of these aspects, individuals can more effectively convey their healthcare preferences and ensure they are respected during critical moments.

Documents used along the form

When preparing for the future, especially in regards to healthcare decisions, it's wise not only to have a Living Will but also to be acquainted with other forms and documents that can complement it. A Living Will, known in Wisconsin as a Declaration to Physicians, allows you to express your wishes about life-sustaining measures if you become incapacitated. However, several other documents can further ensure that your health care preferences are known and respected. Here are some of the key forms and documents often used alongside the Wisconsin Living Will.

  • Power of Attorney for Health Care: This document appoints someone you trust to make healthcare decisions on your behalf if you are unable to do so. It's broader than a Living Will and covers health care decisions not specified in your Living Will.
  • Do-Not-Resuscitate (DNR) Order: A DNR order is a request to not have CPR if your heart stops or if you stop breathing. This is different from a Living Will and must be signed by both the patient and their physician.
  • Declaration of Guardian in the Event of Incapacity: This form lets you choose who will be your guardian if the court decides you need one due to incapacity.
  • Medical Information Release Form (HIPAA Authorization): This gives designated individuals or healthcare providers access to your medical records, ensuring your health care proxy has the information they need to make informed decisions.
  • Organ and Tissue Donation Form: Specifies your wishes regarding organ and tissue donation and can be included in your Living Will or as a separate document.
  • Property Power of Attorney: While not directly related to healthcare, this form designates someone to handle your financial affairs if you are unable to do so, which can be crucial in long-term incapacity.
  • Living Trust: A way to manage your assets during your lifetime and distribute them after your death, potentially avoiding probate. It can include instructions for your care if you become incapacitated.
  • Funeral Planning Declaration: Allows you to document your preferences for funeral arrangements and designate an agent to carry out those wishes. This can relieve your family of making these decisions during a difficult time.

    Utilizing these documents in conjunction with a Living Will can provide a comprehensive legal framework for your healthcare and personal wishes, ensuring that they are honored in various situations. Each document serves a unique purpose, but together, they offer a cohesive strategy for managing your affairs. Consulting with a legal professional can help you understand how best to use these tools to secure your peace of mind and protect your wishes.

Similar forms

The Wisconsin Living Will form shares similarities with the Health Care Power of Attorney. Both documents enable individuals to outline their wishes regarding medical treatment and care. However, while the Living Will specifically addresses the types of life-sustaining treatments a person wishes to accept or refuse in the event they become incapacitated, a Health Care Power of Attorney assigns a trusted individual the authority to make broader health care decisions on behalf of the person if they are unable to do so themselves. This distinction allows for a more comprehensive approach to planning for future health care needs.

Another document akin to Wisconsin's Living Will is the Advance Directive. Like a Living Will, an Advance Directive allows individuals to specify their preferences for medical treatment should they become unable to communicate their wishes. The key difference lies in the scope; Advance Directives can include both a Living Will and a Health Care Power of Attorney, encompassing instructions for health care and the delegation of decision-making power in a single document. This unified approach simplifies the documentation of one's health care preferences.

The Do Not Resuscitate (DNR) Order is also similar to a Living Will but with a more focused application. While a Living Will can cover a range of treatment preferences, a DNR Order specifically instructs medical personnel not to perform CPR or other life-saving measures if the person's breathing stops or if their heart stops beating. This document is particularly relevant for individuals with serious illnesses or those in end-of-life care, where the priority shifts from extending life to ensuring comfort.

The Medical Power of Attorney shares common ground with the Living Will by enabling an individual to influence their future health care when they are unable to make decisions themselves. Unlike a Living Will, which specifies the person's wishes concerning treatment, a Medical Power of Attorney designates another person to make those medical decisions. This allows for flexibility in decision-making, accommodating situations that might not have been foreseen when drafting the Living Will.

A POLST (Physician Orders for Life-Sustaining Treatment) form is another document similar to a Living Will. It translates a person's treatment preferences into medical orders that are immediately actionable by healthcare providers. While a Living Will typically addresses future hypothetical situations, a POLST form is intended for those with serious health conditions and emphasizes current medical preferences regarding treatments like intubation, antibiotic use, and artificial nutrition.A Five Wishes document expands on the Living Will concept by addressing personal, emotional, and spiritual needs in addition to medical wishes. It prompts individuals to reflect on their desires concerning their comfort, how they want to be treated, what they want their loved ones to know, and more, along with specifying the medical treatments they desire or refuse. This comprehensive approach ensures a holistic view of care is considered, beyond just the medical interventions.

The Mental Health Advance Directive, similar to a Living Will, lets individuals make decisions about their future mental health treatment in the event they cannot make decisions for themselves. This specificity is crucial for ensuring that those with mental health conditions receive the care they prefer, including choices about psychiatric medications, hospitalization, and other forms of treatment and support. It addresses a significant and often overlooked aspect of health care planning.

The Last Will and Testament, while primarily focused on the distribution of a person’s estate after death, shares a common intention with the Living Will: to document personal wishes in order to guide future actions. The Last Will and Testament essential ensures that a person's possessions and assets are distributed according to their wishes, thereby alleviating potential disputes among survivors. Though its focus is not on medical decisions, the principle of making one's preferences known in advance to ease the burden on others is a commonality it shares with the Living Will.

Dos and Don'ts

When filling out the Wisconsin Living Will form, certain practices can help ensure your document is both valid and accurately reflects your wishes. Below is a list of things you should and shouldn't do:

Do:
  1. Read instructions carefully to understand each section before you start filling them out.

  2. Use a black or blue pen for clarity and permanence, ensuring the document remains legible over time.

  3. Be clear and specific about your treatment preferences to avoid any ambiguity that might complicate decisions later.

  4. Sign the form in the presence of two witnesses or a notary public, as required by Wisconsin law, to validate the document.

  5. Inform a trusted family member or friend about your Living Will and where it is stored.

Don't:
  1. Leave any sections incomplete; an incomplete form may result in confusion or misinterpretation of your wishes.

  2. Use vague language; be as specific as possible about your medical care preferences to ensure they are understood as intended.

  3. Rely on verbal instructions to family or healthcare providers as a substitute for properly completing your Living Will form.

Misconceptions

When it comes to making future healthcare decisions, many people in Wisconsin turn to a Living Will to express their wishes. However, there are several misconceptions about what a Living Will is and what it covers. Here's a closer look at some of those misconceptions:

  • It covers all healthcare decisions: Many believe that a Living Will covers all potential healthcare decisions. In reality, a Living Will typically focuses on end-of-life care, such as whether to administer life-sustaining treatments if you're terminally ill or in a persistent vegetative state. It does not cover all possible healthcare decisions you might need to make.
  • It takes effect immediately upon signing: Another common misunderstanding is that a Living Will takes effect as soon as it is signed. However, it only comes into play under the specific conditions outlined in the document, such as if you become unable to make your own healthcare decisions due to incapacity.
  • It allows you to appoint a healthcare agent: Some people confuse Living Wills with a Healthcare Power of Attorney. A Living Will does not allow you to appoint someone to make healthcare decisions for you; it only lets you express your wishes regarding life-sustaining treatment. If you want to appoint someone to make decisions on your behalf, you need a separate document, a Healthcare Power of Attorney.
  • It’s only for the elderly: There’s a misconception that Living Wills are only necessary for the elderly. The truth is that any adult can face sudden illness or accidents leading to incapacitation. Having a Living Will in place is a wise decision for adults of all ages, ensuring that your healthcare wishes are known and considered.
  • It overrides all other documents and opinions: Some think that once a Living Will is signed, it overrides all other documents and opinions, including those of family members and healthcare providers. In practice, while a Living Will is legally binding, disputes and challenges can arise, especially if other documents like a Healthcare Power of Attorney exist and conflict with the Living Will. Therefore, it's important to ensure that all your healthcare documents are consistent and updated.
  • A lawyer is needed to create a valid Living Will: While legal advice can be invaluable, especially in complex situations, Wisconsin allows individuals to create their own Living Will without a lawyer. State-provided forms and guidelines make it possible for you to draft a Living Will that reflects your wishes. However, consulting a lawyer can help ensure that your document is thorough, clearly expresses your wishes, and works in harmony with other legal documents you have in place.

Key takeaways

Filling out and using the Wisconsin Living Will form is an important step for many people in planning for the future of their healthcare. This document allows individuals to outline their wishes regarding treatment in situations where they may not be able to communicate their decisions. Here are key takeaways to consider:

  • Understand the purpose: The Wisconsin Living Will is designed to let people make decisions ahead of time about life-sustaining measures in the event they become incapacitated.
  • Meet the criteria: To fill out a Living Will in Wisconsin, one must be at least 18 years old and mentally competent at the time of signing.
  • Witness requirements: Wisconsin law requires the presence of two witnesses when signing the Living Will, neither of whom should be a healthcare provider directly serving the declarant at the time of the document's execution.
  • Notarization is optional: While notarization is not a requirement for a Wisconsin Living Will, getting it notarized may add an extra layer of validity, especially if it's used in another state.
  • Be specific: Clearly outline which life-sustaining treatments you would accept or refuse under certain conditions. Ambiguities can lead to confusion and difficulties in fulfilling one’s wishes.
  • Communicate your wishes: After completing the form, talk to family members and healthcare providers about your decisions, ensuring they understand your wishes.
  • Distribution is key: Give copies of the completed form to your primary physician, a trusted family member, and possibly your healthcare proxy if you have designated one. This ensures that the right people know your wishes and can access them when needed.
  • Review periodically: Life circumstances and viewpoints can change. Review and potentially update your Living Will every few years or after major life events.
  • Keep it accessible: Store your Living Will in a place where it can be easily accessed in an emergency. Some people choose to register their Living Will with a registry or database that healthcare providers can access.

By carefully preparing and managing your Wisconsin Living Will, you can have peace of mind knowing that your healthcare decisions will be respected, even if you're unable to communicate them yourself.

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# Fact Description
1 What It Is A Wisconsin Living Will is a legal document where an individual, known as the declarant, outlines their wishes regarding medical treatment in situations where they are no longer able to communicate or make decisions due to incapacitation.
2 Governing Law In Wisconsin, Living Wills are governed by Chapter 154 of the Wisconsin Statutes. This law outlines the requirements for making a valid Living Will and its legal effects.
3 When It Takes Effect A Living Will only becomes effective when the declarant is in a terminal condition, persistent vegetative state, or is incapacitated to the extent that they cannot communicate healthcare decisions.
4 Requirements for Validity To be valid, a Wisconsin Living Will must be voluntarily signed and dated by the declarant in the presence of two qualified witnesses. These witnesses must meet certain criteria outlined in the statute.
5 Who Cannot be a Witness Witnesses cannot be individuals who are related to the declarant by blood, marriage, or adoption, anyone who has direct financial responsibility for the declarant's medical care, or anyone who will inherit from the declarant upon death.
6 Revocation A declarant may revoke their Wisconsin Living Will at any time, in any manner, without regard to the declarant's mental or physical condition. The revocation becomes effective once it is communicated to the attending physician.
7 Scope of Decisions Covered This document strictly relates to life-sustaining measures and feeding tubes when the individual is in a specified medical condition and does not extend to other aspects of health care decisions.
8 Not a Durable Power of Attorney A Living Will differs from a Durable Power of Attorney for Healthcare in that it only addresses the withholding or withdrawal of life-sustaining measures, whereas a Durable Power of Attorney allows an agent to make a broader range of health care decisions on behalf of the declarant.
9 Public Access Once completed and properly witnessed, a Living Will is not filed with any state agency in Wisconsin and typically remains in the possession of the declarant, their family, or health care provider, keeping its contents relatively private.