03 1 2 PLEASE BE SURE YOU READ THE FORM CAREFULLY AND UNDERSTAND IT BEFORE YOU COMPLETE AND SIGN IT DECLARATION TO PHYSICIANS WISCONSIN LIVING WILL I being of sound mind voluntarily state my desire that my dying not be prolonged under the circumstances specified in this document. Wisconsin.gov To Whom It May Concern Enclosed is the Declaration to Physicians Living Will form you requested. This form makes it possible for adults in Wisconsin to state their preferences for life-sustaining procedures and feeding tubes in the event the person is in a terminal condition or persistent vegetative state. O. Box 2659 Madison Wisconsin 53701-2659. You may make additional copies of the enclosed blank form. The form is also available on the If you have questions about the availability of the Declaration to Physicians Living Will form or obtaining larger quantities of the form you may contact the Division of Public Health at 608 266-1251. 2 Failing to act upon a revocation unless the person or facil....
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How to fill out the WI DHS F-00060 online
This guide provides clear and supportive instructions for filling out the WI DHS F-00060 form, also known as the Declaration to Health Care Professionals. Completing this form is an important step for individuals in Wisconsin to communicate their preferences regarding life-sustaining procedures and feeding tubes in the event of a medical crisis.
Follow the steps to complete the WI DHS F-00060 form online.
- Press the ‘Get Form’ button to access the form online and open it in your preferred editor.
- Begin by entering your full name in the designated field, ensuring it matches the name on your identification documents.
- Indicate your level of understanding by affirming that you are of sound mind to make this declaration.
- Select your preferences for life-sustaining procedures if you are diagnosed with a terminal condition. Choose 'YES' or 'NO' for the use of feeding tubes.
- Repeat the selection for life-sustaining procedures if found in a persistent vegetative state, clearly marking your stance on intervention.
- Complete the section regarding feeding tubes if you are in a persistent vegetative state, again choosing 'YES' or 'NO' as per your wishes.
- Review all of your selections to ensure accuracy and clarity before signing.
- Once satisfied, select the signature areas for both yourself and the two witnesses, ensuring that all signatures occur at the same time.
- After signing, save your changes, and consider downloading or printing the form for your records.
- Distribute copies of the signed form to your physician, family members, and retain the original document in a safe, accessible location.
Complete your WI DHS F-00060 form online today to ensure your health care preferences are communicated.
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Apr 20, 2020 - Wisconsin Department of Health Services. Menu · About DHS ... F-00060...
Enclosed is the Declaration to Physicians (Living Will) form you requested. This form...
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