Forms - Advance Directives

Living Will, Power of Attorney Forms, Authorization for Final Disposition

On this page, you will find the Advance Directives forms:  

Wisconsin State Statute 154

When printing the form from the Internet, please assure that you print and complete all pages of the form you are using. To be valid the form must be complete and signed.


To request individual printed copies

You may request individual advanced directive forms by mailing a self-addressed, stamped, business-size envelope to:

Division of Public Health
ATTN: POA
PO Box 2659
Madison, WI 53703

Please include a note stating which forms you would like to have mailed to you

Postage: For a single stamp (current rate) you may request the following:

4 - Declaration to Physician (Living Will), OR
1 - Power of Attorney for Health Care, OR
1 - Declaration to Physician (Living Will) and 1-Power of Attorney for Health Care, OR
1 - Power of Attorney for Finances and Property

To request 100 or more printed copies

Forms are available in quantities of 100 or more at a cost of:

$15 per hundred for the Power of Attorney for Health Care
$13 per hundred for the Living Will

Make check payable to DHS, and mail to:

Division of Public Health
ATTN: POA
PO Box 2659
Madison, WI 53701-2659

Last Revised: January 26, 2015