Free Wisconsin Advance Directive & Living Will

Build a complete Wisconsin advance directive in minutes — free, no account. Name a health care agent, record your end-of-life wishes, and download a ready-to-sign PDF with Wisconsin's correct signing requirements.

A free directive — not legal or medical advice.

This builds a Wisconsin advance directive: it names a health care agent to decide for you and records your end-of-life wishes. It works only when you sign it as Wisconsin requires (see the signing steps). RecordingLaw.com is not a law firm.

About you

Your health care agent

The person who will make medical decisions if you can't speak for yourself — the most important choice.

Note: in Wisconsin, your agent cannot be For the Power of Attorney for Health Care (Sec. 155.05/155.10), the agent may not be the principal's health care provider, an employee of that provider, or an employee of a health care facility/inpatient facility in which the principal is a patient, UNLESS that person is a relative of the principal. A witness may not be the named agent.

Your end-of-life wishes

If you are terminally ill or permanently unconscious with no recovery expected.

If I am dying and will not recover, I want:

Note: Wisconsin law may suspend these wishes during pregnancy.

Other wishes (optional)

Before you sign — Wisconsin notes

This directive has NO legal effect until you sign it. To make it valid in Wisconsin: Wisconsin uses two separate documents: a Declaration to Physicians (living will, ch. 154) and a Power of Attorney for Health Care (ch. 155). Each must be signed by the declarant/principal and two qualifying witnesses (you and the two witnesses sign together for the declaration). Witnesses cannot be relatives, heirs, persons financially responsible for your care, your health care provider/its employee, or facility employees; the named agent cannot witness. No notary is required. The living-will declaration has NO effect while you are diagnosed as pregnant.

Witness rules: a witness must NOT be Both the Declaration to Physicians (Sec. 154.03) and the Power of Attorney for Health Care (Sec. 155.10) require two witnesses who sign (notary not required; two witnesses only). No witness may be: related to the declarant by blood, marriage, or adoption; have knowledge that they are entitled to or have a claim on any portion of the declarant's estate; directly financially responsible for the declarant's health care; or a health care provider serving the declarant, an employee of that provider (other than a chaplain or social worker), or an employee of an inpatient health care facility in which the declarant is a patient. For the health care POA (155.10), the agent may not act as a witness, and additional restrictions apply (e.g., the health care provider/employee may not be agent or witness).

Your agent cannot be For the Power of Attorney for Health Care (Sec. 155.05/155.10), the agent may not be the principal's health care provider, an employee of that provider, or an employee of a health care facility/inpatient facility in which the principal is a patient, UNLESS that person is a relative of the principal. A witness may not be the named agent.

Pregnancy: Wisconsin law may suspend your living-will instructions while you are pregnant. Wis. Stat. Sec. 154.07(2): the Declaration to Physicians of a qualified patient who is diagnosed as pregnant by the attending health care professional has NO effect during the course of the patient's pregnancy.

Wisconsin also publishes an official statutory directive form (Wis. Stat. Sec. 154.03 (Declaration to Physicians form); Sec. 155.30 (Power of Attorney for Health Care basic form)); this document is a valid alternative that covers the same ground.

After signing, give copies to your agent, your alternate, and your doctor, and keep the original somewhere accessible. An advance directive is not filed with a court.

This is a general-purpose directive and is not legal or medical advice. For complex wishes, a serious illness, or detailed treatment limits, talk to your doctor and an estate-planning attorney. RecordingLaw.com is not a law firm.

Enter your name and your agent's name to download.

Or email yourself a copy (PDF)

Advance Health Care Directive of [YOUR FULL NAME]

PART I — DECLARATION

I, [YOUR FULL NAME], of [CITY], Wisconsin, being of sound mind, make this Advance Health Care Directive to state my wishes for my medical care and to appoint a person to make health care decisions for me if I cannot make them myself. I revoke any prior advance directive, living will, or health care power of attorney I have made.

PART II — MY HEALTH CARE AGENT

I appoint [AGENT NAME] as my health care agent.

My agent's authority takes effect when my attending physician determines that I am unable to make my own health care decisions, and ends if I regain that ability.

My agent may make any health care decision I could make, including consenting to, refusing, or withdrawing any medical care, treatment, or procedure; choosing and changing my doctors and care facilities; and arranging for my comfort and pain relief. My agent must follow my wishes as stated in this document and otherwise act in my best interest.

I authorize my agent to obtain and review my medical information, and I make my agent my personal representative under the Health Insurance Portability and Accountability Act (HIPAA) for that purpose.

PART III — LIVING WILL — MY END-OF-LIFE WISHES

If I am terminally ill, permanently unconscious, or in an end-stage condition with no reasonable expectation of recovery, I do NOT want life-sustaining treatment (such as CPR, a ventilator, or dialysis) that would only prolong the process of dying. I direct that such treatment be withheld or withdrawn and that I be allowed to die naturally, receiving only care for my comfort.

I do NOT want artificially administered nutrition and hydration if it would serve only to prolong the process of dying.

Regardless of my other choices, I always want to be kept as comfortable and free of pain as possible, even if medication to relieve my pain may hasten my death.

Note about pregnancy: under Wisconsin law, this living-will instruction may be limited or suspended if I am pregnant. Wis. Stat. Sec. 154.07(2): the Declaration to Physicians of a qualified patient who is diagnosed as pregnant by the attending health care professional has NO effect during the course of the patient's pregnancy.

PART IV — GENERAL PROVISIONS

This directive is governed by the laws of Wisconsin and is intended to be effective in any place where I may be. A copy of this directive has the same effect as the original. I may revoke it at any time by notifying my agent or health care provider, orally or in writing.

If any part of this directive is held invalid, the rest remains in effect. My health care providers and agent who act in good faith reliance on this directive are protected to the fullest extent of the law.

SIGNATURE

I sign this Advance Health Care Directive willingly, on this _____ day of ____________, 20____, at [CITY], Wisconsin.

____________________________________

[YOUR FULL NAME], Principal

WITNESSES — Each of us declares that the principal signed this directive in our presence, appeared to be of sound mind and free from duress, that we are each at least 18 years old, and that we are not disqualified from witnessing under this state's law (see the signing instructions for who may not witness).

Witness 1: ____________________________ Address: ____________________________

Witness 2: ____________________________ Address: ____________________________

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