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REVOCATION OF POWER OF ATTORNEY FOR HEALTH CARE Wisconsin Statutes 155. 40 I Declarant executed a Power of Attorney For Health Care on the day if I were to be incapable of making those decisions. me at any time by any of the following methods 155. 40 1 a a Canceling defacing obliterating burning tearing or otherwise destroying the power of attorney for health care instrument or directing another in the presence of the principal to so destroy the power of attorney for health care instrument. b Executing a statement in writing that is signed and dated by the principal expressing the principal s intent to revoke the power of attorney for health care. c Verbally expressing the principal s intent to revoke the power of attorney for health care in the presence of 2 witnesses. d Executing a subsequent power of attorney for health care instrument. This is my written revocation of my Power of Attorney For Health Care and is provided to all persons to whom I have provided a copy of my Power of A....

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The Power of Attorney for Health Care (POA-HC) Form (DHS Form F-00085) makes it possible for adults in Wisconsin to authorize other individuals (called health care agents) to make health care decisions on their behalf should they become incapacitated.

A Wisconsin medical power of attorney lets a person select a health care agent to step in and make decisions if a patient becomes incapacitated. The patient can make special instructions for the agent and must be signed with two (2) witnesses to be legal.

(2) A witness to the execution of a valid power of attorney for health care instrument shall be an individual who has attained age 18....155.20(2)(a)1. An institution for mental diseases, as defined in s. ... An intermediate care facility for persons with an intellectual disability, as defined in s.

One copy of the Power of Attorney for Health Care form is available free to anyone who sends a stamped, self-addressed, business-size envelope to: Power of Attorney, Division of Public Health, P.O. Box 2659, Madison, Wisconsin 53701-2659.

The principal must also sign the document in the presence of two disinterested witnesses. To be a disinterested witness, the witness cannot be a rela- tive (by blood or marriage); the health care provider or an employee of the health care provider, unless a social worker or a chaplain; or the HCPOA agent.

Most Power of Attorney for Health Care documents provide that the document becomes “activated” when two physicians or one physician and one psychologist personally examine the principal and then sign a statement certifying that the principal is incapacitated.

While Wisconsin does not technically require you to get your POA notarized, notarization is strongly recommended. Under Wisconsin law, when you sign your POA in the presence of a notary public, you signature is presumed to be genuine—meaning your POA is more ironclad.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232