Wisconsin Templates
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Outline

The Wisconsin F 00060 form, officially known as the Declaration to Health Care Professionals, serves a crucial role in allowing individuals to express their wishes regarding medical treatment in the event they find themselves in a terminal condition or a persistent vegetative state. This document empowers adults to make informed decisions about life-sustaining procedures and feeding tubes, ensuring that their preferences are respected when they can no longer communicate them. It is essential for individuals to carefully read and understand the form before completing and signing it, as this ensures that their intentions are clearly articulated. The form requires the presence of two witnesses, who must meet specific criteria to validate the declaration. These witnesses cannot be related to the individual or have any financial responsibility for their healthcare, ensuring that the process remains unbiased and respectful of the individual’s wishes. Once the form is signed, it is vital to keep the original in a safe yet accessible location, and to inform family members and healthcare providers about its existence. This declaration can be a powerful tool in navigating the complexities of end-of-life care, offering peace of mind to both the individual and their loved ones by providing clarity during difficult times.

Steps to Filling Out Wisconsin F 00060

Completing the Wisconsin F 00060 form is an important step in expressing your health care preferences. Once you have filled out the form, it will need to be signed in the presence of two witnesses. Make sure to keep the signed document in a safe place and inform family members about its location. You may also choose to file a copy with your health care provider or the Register in Probate for safekeeping.

  1. Obtain the Wisconsin F 00060 form. You can download it from the Department of Health Services website or request a copy by mail.
  2. Read the entire form carefully, including the definitions and instructions, to understand its implications.
  3. Fill in your full name, address, and date of birth at the top of the form.
  4. Indicate your preferences regarding life-sustaining procedures and feeding tubes under the specified conditions by checking the appropriate boxes.
  5. Sign the form in the designated area, ensuring you do so voluntarily and while of sound mind.
  6. Have two witnesses sign the form. Ensure that they are at least 18 years old, not related to you, and not financially responsible for your health care.
  7. Provide the date of signing next to your signature and the witnesses' signatures.
  8. Make copies of the signed form for your records and share the location of the original with family members.
  9. Consider filing a copy with your physician or the Register in Probate if you wish to have it officially recorded.

Key takeaways

Here are some important points to consider when filling out and using the Wisconsin F 00060 form, also known as the Declaration to Health Care Professionals:

  • Purpose of the Form: This form allows adults in Wisconsin to express their wishes regarding life-sustaining procedures and feeding tubes in specific medical conditions.
  • Understanding the Document: It is crucial to read both sides of the form carefully before signing. Ensure you fully understand its implications.
  • Witness Requirements: Two witnesses must sign the form. They must be at least 18 years old, not related to you, and not financially responsible for your health care.
  • Storage and Notification: Keep the original signed form in a safe, accessible location. Inform family and friends about its existence and where it is stored.
  • Medical Records: Notify your attending physician or health care provider about the Declaration. They should include it in your medical records.
  • Revocation Rights: You can revoke the Declaration at any time through various methods, such as written notice or verbal expression, as long as your health care provider is informed.

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Documents used along the form

The Wisconsin F 00060 form, also known as the Declaration to Health Care Professionals or Living Will, is an important document that outlines a person's wishes regarding medical treatment in specific situations. Alongside this form, several other documents can help clarify health care preferences and legal rights. Here’s a list of commonly used forms and documents that often accompany the F 00060 form.

  • Power of Attorney for Health Care: This document allows you to appoint someone to make medical decisions on your behalf if you become unable to do so. It provides a clear directive about your health care preferences.
  • Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform CPR if your heart stops or you stop breathing. This document is typically used in emergency situations.
  • Advance Directive: An advance directive is a broader term that includes both living wills and powers of attorney. It outlines your wishes regarding medical treatment and end-of-life care.
  • Organ Donation Registration: This document specifies your wishes regarding organ donation after death. It can be part of your driver's license or a separate form.
  • Health Care Proxy: Similar to a power of attorney, a health care proxy designates someone to make medical decisions for you when you are unable to communicate your wishes.
  • Medical History Form: This form provides health care professionals with important background information about your medical history, medications, and allergies, helping them make informed decisions about your care.
  • Affidavit of Residency: For those verifying their residence in Florida, the official Florida Affidavit of Residency form guide provides essential information on completing this legal document accurately.
  • Patient Information Sheet: This document includes personal details, emergency contacts, and health insurance information, ensuring that medical staff can contact the right people if needed.
  • Living Will Registry: Some states offer a registry where you can file your living will. This makes it easier for health care providers to access your wishes when necessary.
  • HIPAA Authorization Form: This form allows you to grant permission for specific individuals to access your medical records, ensuring that your privacy is respected while allowing trusted people to be involved in your care.

Having these documents in place can help ensure that your health care wishes are respected and understood. It's always a good idea to discuss these forms with your family and health care providers to ensure everyone is on the same page. Remember to keep copies of these documents in an accessible location and inform your loved ones about their existence.