Patient Center
Advance Medical Directives

Wisconsin-Specific Forms

Meriter recommends that all people clarify their wishes for medical care before a hospital stay. Five Wisconsin-specific forms are available through this site:

• Power of Attorney Form

   
   

• Addendum to the Power of Attorney Form

  (Optional) Assistance with helping you make treatment choices.
  Reprinted by permission from A Gift to Your Family.
   
   

• Declaration to Physicians Form

  
   

• Power of Attorney Form

  (customized for Jehovah's Witnesses)
  
   

 
If you have questions about filling out these forms, please call Meriter Patient & Family Services or Meriter Spiritual Care at (608) 417-6000.

The above forms are Adobe Acrobat files. To open these files, you need to have Adobe Acrobat Reader (a free plug-in) on your computer.
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5/19/2009