Laws
Statute – Wisconsin Statutes § 154-01 – 154-30
Definitions – § 154-01 – 154-02
Signing Requirements – The document must be signed before two (2) viable witnesses to validate the declaration. State law additionally stipulates the following regarding witness acceptability:
“No witness to the execution of the declaration may, at the time of the execution, be any of the following:
(a) Related to the declarant by blood, marriage or adoption.
(b) Have knowledge that he or she is entitled to or has a claim on any portion of the declarant’s estate.
(c) Directly financially responsible for the declarant’s health care.
(d) An individual who is a health care provider, as defined in §155-01(7), who is serving the declarant at the time of execution, an employee, other than a chaplain or a social worker, of the health care provider or an employee, other than a chaplain or a social worker, of an inpatient health care facility in which the declarant is a patient.” (§ 154-03(1))
Other Versions (5)
- AARP (Caring Connections)
- Ascension Wisconsin
- Aurora Health Care
- Five Wishes (Aging with Dignity)
- Prepare for Your Care
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Ascension Wisconsin Advance Directive Form
Download: Adobe PDF
Aurora Health Care Advance Directive Form (also available in Spanish/en Español)
Download: Adobe PDF
Large Print Version: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Additional Resources
- Aurora Health Care – Advance Care Planning Guide
- Froedtert & Medical College of Wisconsin – Making an Advance Directive
- State Bar of Wisconsin – Health Care: Answering your Legal Questions
- University of Wisconsin – Advance Directives for Health Care
- U.S. Department of Health and Human Services – Your Rights under HIPAA
- Wisconsin Department of Health Services – End of Life Planning
- Wisconsin Department of Health Services – Do-Not-Resuscitate (DNR) Information
- Wisconsin Department of Health Services – Wisconsin Consumer’s Guide to Health Information Privacy
Related Forms (5)
- Advance Directive Wallet Card
- Document of Anatomical Gift
- Durable (Financial) Power of Attorney Form
- DNR (Do-Not-Resuscitate) Order
- HIPAA Release Authority
Download: Adobe PDF
Document of Anatomical Gift – Authorization for Organ and Tissue Donation Form F-43025 (also available in Spanish/en Español)
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF
Emergency Care Do Not Resuscitate Order (DNR) Form F-44763
Download: Adobe PDF
Health Care Power of Attorney Addendum – HIPAA Release Authority
Download: Adobe PDF
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