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  • Wi F-00085 2020

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State of Wisconsin Department of Health Services Instructions to Complete the Power of Attorney for Health Care Form To Whom It May Concern: Enclosed is the Power of Attorney for Health Care form.

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How to fill out the WI F-00085 online

The WI F-00085, also known as the Power of Attorney for Health Care form, allows individuals in Wisconsin to designate someone to make health care decisions on their behalf in the event of incapacitation. This guide provides clear, step-by-step instructions to help you complete this important document online.

Follow the steps to fill out the WI F-00085 successfully.

  1. Click ‘Get Form’ button to download the Power of Attorney for Health Care form and open it in your preferred editor.
  2. Begin by entering your full name, address, and date of birth in the designated space at the top of the form. Make sure all information is accurate and complete.
  3. Designate your primary health care agent by printing their name, address, and telephone number. Also, identify an alternate agent in case your primary agent is unable to act.
  4. Review the general statement of authority granted to your agent. Confirm that your agent understands your health care preferences and that they are prepared to make decisions on your behalf.
  5. Specify any limitations on your health care agent's authority, especially regarding mental health treatment and admissions to nursing homes or community-based facilities.
  6. If you have specific desires or special provisions related to your health care, clearly state these in the provided space. This may include any limitations concerning life-sustaining treatment.
  7. Sign and date the document in the principal's section to confirm that you understand its contents and are executing it voluntarily.
  8. Two witnesses must sign the form at the same time you do. Ensure that your witnesses meet the criteria outlined in the form.
  9. Finally, consider whether to make an anatomical gift upon your death. Fill out the corresponding section if you wish to include any desires regarding such gifts.
  10. Upon completing the form, ensure that all pages are kept together. You can save changes, download, print, or share the completed document as needed.

Complete your Power of Attorney for Health Care document online today to ensure your health care preferences are known.

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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.

If you initialed "real property," giving your agent the power to conduct transactions with real estate, you should also file a copy of your POA in the land records office in the county where you own real estate or expect to deal with real estate in the future. In Wisconsin, this office is called the register of deeds.

This Power of Attorney authorizes another person (your agent) to make decisions concerning your property for you (the principal). Your agent will be able to make decisions and act with respect to your property (including your money) whether or not you are able to act for yourself.

Upon revocation, the agent no longer has authority to act through that POA. Only the principal or the court (including as a result of a court's action such as granting a divorce) may revoke a POA.

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.

Steps for Making a Financial Power of Attorney in Wisconsin Create the POA Using a Statutory Form, Software, or Attorney. ... Sign the POA in the Presence of a Notary Public. ... Store the Original POA in a Safe Place. ... Give a Copy to Your Agent or Attorney-in-Fact. ... File a Copy With the Land Records Office.

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.

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