Wisconsin Power of Attorney for Health Care

Appoint an agent to make health care decisions for you if you should become unable to do so with this easy-to-use Power of Attorney for Health Care, for Wisconsin residents.

• By naming someone you trust to act as your health care agent, you can ensure that your instructions about medical treatments and procedures will be given to your attending physician, even if you are not able to communicate those instructions.
• The form includes separate sections for:
  • limitations on mental health treatment,
  • admission to nursing home or residential facility,
  • provision of feeding tube,
  • health care decisions for pregnant women,
  • organ donation.
• The package includes information and instructions to help you complete the form.
• Available in MS Word format. This is a reusable form, and multiple members of the family can each use the same form.
• Intended to be used only in the State of Wisconsin.