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Planning for the future involves thinking through scenarios we often prefer to avoid, particularly those concerning our health and well-being. Wisconsin residents have the option of completing a Living Will form, a legal document that allows individuals to outline their preferences for medical treatment should they become unable to communicate their wishes due to illness or incapacity. This critical document serves as a guide for family members and healthcare providers, ensuring that the person's healthcare choices are respected even when they are unable to articulate them. The form covers various aspects of end-of-life care, including the desire for life-sustaining treatments, artificial nutrition, and hydration, among other important medical decisions. By having a Living Will in place, individuals can provide clear instructions regarding their healthcare, relieving their loved ones from the burden of making those difficult decisions during emotionally challenging times. Furthermore, it helps to avoid potential conflicts or disagreements among family members regarding the preferred course of treatment. Understanding and completing the Wisconsin Living Will form is a proactive step towards ensuring one's wishes are honored, promoting peace of mind for both the individual and their family.

Sample - Wisconsin Living Will Form

Wisconsin Living Will

This Living Will is designed to reflect the desires and directives of the undersigned, regarding health care decisions, in accordance with the Wisconsin Declaration to Physicians (Wisconsin Statutes Chapter 155). This document allows you to express your wishes about refusing or accepting life-sustaining treatment if you are unable to communicate due to illness or injury.

Please complete the following information:

Name: ___________________________________________________________

Address: ________________________________________________________

City, State, Zip: _________________________________________________

Date of Birth: ___________________________________________________>p>

Social Security Number: ___________________________________________

Section 1: Declaration

I, __________________________________________ [your name], being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below. I hereby declare that:

If at any time I should have an incurable and irreversible condition that will cause my death within a relatively short time, and I am no longer able to make decisions regarding my medical treatment, I direct the following:

  1. That all treatments other than those needed to keep me comfortable be discontinued or withheld and my health care providers allow me to die naturally and only administer treatment that alleviates pain and suffering.
  2. Specific treatments I want refused or provided: ____________________________________
  3. In the event that I am unable to communicate my wishes directly, I appoint the following person as my health care agent: Name: ___________________________________________________________ Relationship: ____________________________________________________ Phone Number: ___________________________________________________

Section 2: Special Provisions and Limitations

My agent shall not have any authority over my estate, finances, or any other matters other than those related to my health care.

Section 3: Signatures

This document is executed in accordance with the laws of the State of Wisconsin, and I understand the consequences of this declaration.

Signature: ___________________________________________ Date: ____________________

Witness 1: ___________________________________________ Date: ____________________

Address: ________________________________________________________________________

Witness 2: ___________________________________________ Date: ____________________

Address: ________________________________________________________________________

Notice: This living will should be kept in a place where it is easily accessible in the event it is needed. Copies of this document should be given to your health care agent, family members, and your primary physician.

PDF Form Information

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Fact Name Detail
Legal Name Wisconsin Living Will
Also Known As Declaration to Physicians
Governing Law Wisconsin Statutes Chapter 154
Purpose To allow an individual to outline preferences for end-of-life medical care
Who Can Create One Any competent individual who is 18 years of age or older
Required Signatures The declarant and two witnesses

How to Write Wisconsin Living Will

The Wisconsin Living Will form is an essential document for residents who wish to outline their preferences for medical treatment in the event they are unable to communicate their decisions due to a serious health condition. Completing this form ensures that one's healthcare wishes are known and can be acted upon by medical professionals and loved ones. This process not only grants peace of mind to the individual but also guides family members during challenging times. The steps below are designed to aid in completing the form accurately and efficiently.

  1. Obtain the most current version of the Wisconsin Living Will form from the Wisconsin Department of Health Services website or a reliable legal forms provider.
  2. Read the entire form carefully before filling it out to understand all the provisions and how they apply to your personal wishes regarding medical treatment.
  3. Print your full legal name, date of birth, and address at the top of the form to establish your identity as the declarant.
  4. In Section 1, specify the circumstances under which you would want to refuse life-sustaining measures or feeding tubes. This typically relates to situations where recovery is not expected.
  5. In Sections 2 and 3, you may provide additional instructions regarding the refusal of life-sustaining measures and the use of feeding tubes. Here, you can detail your preferences clearly and concisely.
  6. If you have specific desires about organ donation, Section 4 allows you to express those wishes. Indicate whether you want to donate your organs and for what purposes, such as transplantation, therapy, research, or education.
  7. Designate a healthcare agent in Section 5, if you wish. This person would make healthcare decisions on your behalf should you become unable to do so. Provide their full name, relationship to you, and contact information.
  8. Review the form to ensure all your instructions are clearly stated and reflect your wishes accurately. Make any necessary adjustments.
  9. Sign and date the form in the presence of two witnesses who are not your healthcare provider, not related to you by blood, marriage, or adoption, and who do not stand to inherit any part of your estate. Both witnesses must also sign and date the form, attesting to your voluntary and competent execution of the document.
  10. Inform your healthcare provider and close family members or friends of your Living Will and provide them with copies. It's important to have this conversation to ensure your wishes are understood and accessible when needed.

After completing these steps, your Wisconsin Living Will is valid and should be kept in a safe place where it is easily accessible. Remember, this document can be updated or revoked at any time should your healthcare preferences change. Providing copies to your healthcare proxy, family members, and healthcare providers ensures that your end-of-life wishes are honored without ambiguity.

Key Details about Wisconsin Living Will

What is a Wisconsin Living Will?

A Wisconsin Living Will is a legal document where a person can outline their health care preferences in the event they become incapacitated and unable to communicate their decisions. It specifically deals with situations involving life-sustaining procedures when a person has a terminal condition or is in a persistent vegetative state.

How does one create a Wisconsin Living Will?

To create a Wisconsin Living Will, an individual must complete the required form, adhering to the state's legal requirements. This typically involves outlining your health care preferences, signing the document in the presence of two witnesses, and ensuring the witnesses meet the eligibility criteria set by Wisconsin law.

Who can be a witness for a Wisconsin Living Will?

In Wisconsin, witnesses to a Living Will must be at least 18 years of age. Witnesses cannot be related to the individual by blood, marriage, or adoption, and cannot have a financial interest in the individual's estate. Additionally, health care providers who are currently treating the individual cannot serve as witnesses.

Is a Wisconsin Living Will revocable?

Yes, a Wisconsin Living Will can be revoked at any time by the creator, regardless of their mental state. Revocation can be done in several ways, including through a written document specifying the intent to revoke, destroying the document physically, or orally expressing the desire to revoke the document in front of a witness.

Does a Wisconsin Living Will need to be notarized?

No, a Wisconsin Living Will does not need to be notarized. However, it must be signed in the presence of two eligible witnesses, who must also sign the document, affirming that the creator is of sound mind and acting without duress or undue influence.

What should be done with a completed Wisconsin Living Will?

After completing a Wisconsin Living Will, it is advisable to inform family members, a health care agent (if one has been appointed), and primary care physicians about the document. Copies should be provided to these individuals and any other relevant health care providers to ensure the wishes outlined are respected and followed.

Common mistakes

Filling out a living will in Wisconsin is a responsible step toward ensuring one's healthcare preferences are honored. However, several common mistakes can compromise the document's effectiveness. Being aware of these pitfalls can help individuals avoid them and create a more robust living will.

Not Completing All Required Sections: One of the first mistakes often made is leaving sections of the form incomplete. Every part of the Wisconsin Living Will form is designed to capture important information about your healthcare preferences. Neglecting to fill out any section may lead to ambiguity regarding your wishes.

Forgetting to Sign in the Presence of Witnesses: The validity of a living will in Wisconsin hinges on not just your signature, but also on it being witnessed by others. Failing to sign the form in the presence of qualified witnesses, or neglecting to have witness signatures at all, can render the document legally ineffective.

  1. Using unclear language or medical terminology not widely understood can lead to misinterpretation of your wishes.
  2. Choosing witnesses who do not meet state requirements. In Wisconsin, witnesses to a living will cannot be healthcare providers directly involved in your care or financially responsible for your medical bills.
  3. Forgetting to update the living will after major life changes, such as marriage, divorce, or a significant shift in health status. This oversight can lead to an outdated document that does not reflect current wishes.
  4. Assuming a living will is only for the elderly or those with a terminal illness. People of all ages can face sudden medical crises, and having a living will is a proactive measure for anyone.
  5. Not discussing the contents of the living will with healthcare providers. Simply completing the form is not enough; it is crucial that your doctor is aware of its existence and understands your preferences.
  6. Neglecting to distribute copies of the living will to important parties, such as family members, healthcare agents, and primary physicians. Failing to do so can result in your wishes not being known or followed in a critical moment.

In sum, when filling out a Wisconsin Living Will form, it is vital to complete all sections, choose qualified witnesses, use clear language, regularly update the document, communicate with healthcare professionals, and distribute copies to relevant parties. Avoiding these common mistakes can help ensure that your healthcare preferences are understood and respected.

Documents used along the form

When preparing for the future, especially in terms of healthcare preferences, the Wisconsin Living Will form is a critical document that reflects your choices regarding life-sustaining treatments should you become unable to communicate your wishes. However, this document does not stand alone when planning for such important decisions. Several other forms and documents often accompany a Living Will to ensure a comprehensive approach to healthcare planning. Understanding each document’s role will enhance the effectiveness of your healthcare directives.

  • Health Care Power of Attorney - This legal document grants another person (often called an agent) the authority to make healthcare decisions on your behalf if you are unable to do so. It complements the Living Will by covering health care decisions that might not be specified within the Living Will itself.
  • Do Not Resuscitate (DNR) Order - A critical form for those who wish to avoid CPR or advanced life support measures if their heart stops or they stop breathing. This document must be signed by both the individual and their physician.
  • Declaration to Physicians (Wisconsin Statutory Power of Attorney for Health Care) - Similar to a Living Will, this document specifies your wishes regarding life-sustaining procedures but is specifically tailored to Wisconsin’s statutes, offering an alternative or complement to the Living Will.
  • HIPAA Release Form - Ensures that your health care agents have access to your medical records, allowing them to make informed decisions. This form is crucial for the practical implementation of your healthcare wishes.
  • Organ and Tissue Donation Form - Specifies your wishes regarding organ and tissue donation after your death. It can be included as part of your Living Will or as a separate document registered with a donor registry.
  • Funeral Directives - Though not always strictly legal documents, these directives allow you to express your preferences for your funeral arrangements, including burial or cremation, type of ceremony, and other personal touches.

Understanding and preparing these documents in conjunction with your Living Will ensure that your healthcare preferences are respected and followed. It's about taking control of your health care and end-of-life decisions, providing peace of mind for both you and your loved ones. Consulting with a healthcare attorney can help navigate the complexities of these documents, ensuring that your rights are protected and your wishes are clearly articulated.

Similar forms

The Wisconsin Living Will closely resembles the Health Care Power of Attorney in its objective to prepare for future healthcare decisions. While a Living Will specifies an individual's preferences concerning treatment options in the event they are incapacitated and cannot communicate their wishes, the Health Care Power of Attorney allows an individual to appoint another person to make healthcare decisions on their behalf under similar circumstances. Both documents are proactive steps to ensure that healthcare decisions align with the individual's values and desires when they cannot speak for themselves.

Similarly, the Do Not Resuscitate (DNR) order is another document that shares a common goal with the Wisconsin Living Will. A DNR specifically instructs medical professionals not to perform CPR (cardiopulmonary resuscitation) if an individual’s breathing stops or if their heart stops beating. While the Living Will can cover a broad array of medical treatments and scenarios, including the use of life-prolonging devices and treatments, a DNR is focused solely on the absence of CPR. Both documents guide healthcare providers on how to proceed in critical situations according to the patient's wishes.

The Declaration to Physicians (Wisconsin form) or Physician Orders for Life-Sustaining Treatment (POLST) form is another document that bears similarities to the Wisconsin Living Will, yet serves a slightly different function. This form is designed for individuals with serious health conditions and makes specific medical orders available to healthcare providers. Much like a Living Will, it guides medical treatment based on the patient's wishes. However, it is more immediate and actionable, focusing on current conditions rather than future incapacitation, ensuring that the patient’s treatment preferences are followed during any medical interaction.

Last, the Financial Power of Attorney is related to the Living Will through its fundamental purpose of planning for the future, but it diverges in focus. While the Living Will deals with healthcare decisions, the Financial Power of Attorney designates someone to handle financial affairs and decisions on behalf of the individual. Both documents are crucial in preemptive planning, ensuring that personal matters are managed according to one's preferences should they become unable to do so themselves due to incapacitation or other reasons. The preservation of autonomy across different aspects of one's life links these documents closely together.

Dos and Don'ts

Completing a Wisconsin Living Will is a crucial step in healthcare planning, allowing individuals to articulate their wishes concerning life-sustaining treatments in the event they are unable to communicate these themselves. Here is a guide to help ensure the process is done accurately and effectively.

Do:

  1. Read all instructions carefully before beginning to fill out the form. This ensures you understand each section and its significance.
  2. Be specific about your medical treatment preferences. Detailing your wishes clearly can prevent any misunderstandings in the future.
  3. Sign the document in the presence of two witnesses or a notary public. Wisconsin law requires your Living Will to be witnessed to be considered valid.
  4. Inform your family, healthcare agent, and primary physician that you have completed a Living Will and provide them with a copy. This step is crucial to ensure your wishes are followed.

Don't:

  • Leave any sections blank. If a section does not apply to you, write "N/A" (not applicable) to indicate this. Incomplete forms may lead to confusion or be deemed invalid.
  • Use ambiguous language. Be clear and concise to ensure your wishes are understood exactly as intended.
  • Forget to update your Living Will regularly. Review and revise your document as necessary, especially after significant life changes.
  • Assume that your healthcare provider is aware of your Living Will without notification. Always provide your healthcare team with the most current copy of the document.

Misconceptions

When discussing a Wisconsin Living Will, a document that outlines a person's wishes regarding medical treatment in the event they cannot communicate them, several misconceptions commonly surface. It’s vital to clarify these misunderstandings to ensure individuals can make informed decisions about their healthcare futures.

  • Misconception 1: A Living Will is the same as a Last Will and Testament. The two documents serve different purposes; a Living Will guides medical decisions when a person is incapacitated, whereas a Last Will and Testament addresses the distribution of an individual's estate after their death.

  • Misconception 2: Only the elderly need a Living Will. Health crises can occur at any age, and having a Living Will is important for any adult to ensure their healthcare wishes are known and respected, regardless of their age.

  • Misconception 3: Your family can override your Living Will. A Living Will is legally binding, and healthcare providers are obligated to follow it, even if the family's wishes differ. The document specifically guides healthcare professionals on how to proceed in situations outlined within it.

  • Misconception 4: A Living Will is difficult to change. As long as you are competent, you can revoke or modify your Living Will at any time to reflect your current wishes. Changes must be made following the state's guidelines to ensure the updated document is legally valid.

  • Misconception 5: A Living Will becomes effective as soon as it is signed. The activation of a Living Will's directives depends on specific medical conditions being met, typically when a person is deemed unable to make their own healthcare decisions.

  • Misconception 6: Once you appoint a healthcare agent in a Living Will, your decision is final. You can update your choice of healthcare agent as your relationships or circumstances change, ensuring the individual you trust most is making decisions on your behalf.

  • Misconception 7: You need a lawyer to create a Living Will. While legal advice can be helpful, especially in complex situations, you can create a Living Will on your own. However, it must meet Wisconsin's legal requirements, including witness or notarization stipulations, to be considered valid.

Understanding these points helps demystify the process and importance of establishing a Wisconsin Living Will. It encourages individuals to take thoughtful steps towards managing their healthcare wishes for the future.

Key takeaways

When individuals in Wisconsin decide to create a Living Will, there are several important considerations to keep in mind. This document serves as a declaration of one's wishes regarding medical treatment in the event that they become unable to voice these desires themselves. Below are key takeaways about filling out and using the Wisconsin Living Will form.

  • Residents of Wisconsin have the right to make decisions about their health care, including the right to accept or refuse medical treatment. A Living Will is a legal document that outlines these preferences.
  • It is crucial to familiarize oneself with the specific requirements and guidelines established by Wisconsin law for creating a valid Living Will.
  • The Living Will form should be completed when the person is of sound mind, ensuring that their decisions are made without any external pressure and reflect their true wishes.
  • Clear communication with family members and healthcare providers about one’s existence of a Living Will and its contents can prevent any confusion or conflict during critical moments.
  • Choosing a health care agent or proxy, who is entrusted with the task of ensuring that the wishes documented in the Living Will are honored, should be done with careful consideration.
  • It’s essential to review and update the Living Will periodically, especially after significant life events such as marriage, divorce, the birth of a child, or a change in health status.
  • For the document to be legally binding, it must meet Wisconsin's statutory requirements, such as being signed in the presence of witnesses or a notary public.
  • Finally, it’s advisable to consult with a legal professional to ensure that the Living the Living Will accurately reflects the person’s wishes and complies with Wisconsin law.

By adhering to these guidelines, individuals can provide clear instructions about their health care preferences, offering peace of mind to themselves and their loved ones.

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