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STATE OF WISCONSIN Ch. 154 Wis. Stats PO Box 2659 Madison, WI 537012659 608 2661568DEPARTMENT OF HEALTH SERVICES DIVISION OF PUBLIC HEALTH F44763 (Rev 07/2020) Page 1 of 2EMERGENCY CARE DO NOT RESUSCITATE.

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How to fill out the WI F-44763 online

This guide provides clear and comprehensive instructions on how to fill out the WI F-44763 form, also known as the Do Not Resuscitate Order. Whether you are a person seeking to document your wishes, a legal guardian, or a health care agent, this guide will help you navigate the process with ease.

Follow the steps to complete your WI F-44763 form effectively.

  1. Press the 'Get Form' button to obtain the WI F-44763 form, which will open it in your document editor.
  2. In the designated field, print the patient's name clearly. Ensure that all spelling is correct to avoid issues later.
  3. Fill in the patient's address, including street, city, state, and zip code in the appropriate spaces.
  4. Enter the patient's date of birth in the specified format. Make sure it aligns with other provided information.
  5. In the section for the signer, indicate who is signing the document by circling the appropriate title (patient, legal guardian, or health care agent).
  6. Have the signer provide their signature and include the date of signing in the designated space.
  7. The attending health care professional must print their name and telephone number in the provided fields. They will also need to sign and date the form.
  8. Ensure that all required signatures and dates are present, as these are essential for the order to be valid.
  9. After completing the form, users can choose to save the changes, download a copy, print the document, or share it with others if necessary.

Complete your WI F-44763 form online today and ensure your wishes are documented accurately.

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