Free Wisconsin Medical Power of Attorney Forms

Wisconsin Medical Power of Attorney Laws

The legislation governing medical POAs in Wisconsin is in Chapter 15 of the state legislature. The statute defines healthcare as “any care, treatment, service or procedure to maintain, diagnose or treat an individual's physical or mental condition” and a healthcare decision as “an informed decision in the exercise of the right to accept, maintain, discontinue or refuse health care” (WI Stat § 155.10(1)(c)).

The legislation states that the healthcare agent must always act in good faith with the principal’s wishes and preferences, or their best interests should preferences be unknown, when the principal is incapacitated or deemed incompetent (WI Stat § 155 (Power of Attorney for Health Care)).

Signing Requirements in Wisconsin

A medical POA in Wisconsin must be signed by the principal (or a person of legal age who is directed to sign by the principal) in the presence of two adult witnesses. Witnesses cannot be any of the following (WI Stat § 155.10(1)(c)).

(a) Related to the principal by blood, marriage, or adoption, or the domestic partner under Ch. 770 on individuals.

(b) Have knowledge that they are entitled to or has a claim on any portion of the principal's estate.

(c) Directly financially responsible for the principal's health care.

(d) An individual who is a health care provider who is serving the principal 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 principal is a patient.

(e) The principal's health care agent.

How To Write a Medical POA in Wisconsin

Creating a medical POA of your own in Wisconsin can be done by using a free printable template or writing your own POA form from scratch. Below are the steps you need to take to write a POA in Wisconsin.

1. Choose your agent

The agent acts on behalf of the principal in all healthcare-related matters. For this reason, the principal needs to have full trust in the person appointed to the role. Make sure that time and thought are given to the appointment.

2. Personal information

Your POA needs to include the full legal name and address of the principal, as well as the same for the agent. You will also need to have up-to-date contact details for the agent.

3. Declaration

Your POA needs to include a declaration to satisfy any court that the principal created the POA voluntarily and wasn’t forced to do so under duress. It must state that the principal is of sound mind and is of legal age.

4. Instructions and preferences

Due to the nature of a medical POA, this section needs to be thorough so that the agent can always act in good faith. They will need clear instructions regarding the principal's wishes for things like palliative care, organ donation, and life-sustaining treatments.

5. Duration of the POA and revocation terms

Your POA must include information on the duration and revocation terms. While many healthcare POAs come into effect during declining illness, some may be revoked should the principal recover. Make sure to set out conditions for revocation of the medical POA.

6. Alternate agents

In the event that the appointed agent cannot take on the role, it is in the best interests of the principal for an alternate agent to be named. Include personal information and contact details for one or two alternate healthcare agents.

7. Principal and witness signatures

For your medical POA to take effect, it must be signed by the principal in the presence of two adult witnesses. In some cases, the principal may direct another individual to sign the POA, provided they are of legal age.

8. Effective date

Ensure that your POA has a date stating when it becomes effective.