POWER OF ATTORNEY FOR HEALTH CARE

The Power of Attorney for Health Care makes it possible for adults in the state of Wisconsin to authorize other individuals (called health care agents) to make health care decisions on their behalf should they become incapacitated. It may also be used to make or refuse to make an anatomical gift (donation of all or part of the human body) to take effect on or after the death of the donor. To create a Power of Attorney for Health Care, you must:

  • Be at least 18 years of age and of sound mind
  • Have two witnesses who are unrelated to you and have no knowledge of any inheritance, are not financially responsible to you, are the person you select to make decisions for you if you become legally unable and are not your health care provider
  • Choose someone to make your health care decisions if you are unable to do so
  • Submit the completed Power of Attorney for Health Care document to GHC-SCW
  • Understand that the person whom you choose to serve in this capacity is not financially responsible for decisions made
  • Understand that you may revoke you Power of Attorney for Health Care and invalidate the document at any time

While the Power of Attorney for Health Care form does have limits, it is broad and flexible. It requires that the person you choose must act in good faith, and be consistent with your wishes and desires documented in the Power of Attorney for Health Care.

To obtain a copy of the Power of Attorney for Health Care document, contact the GHC-SCW Member Services Department at (608) 828-4853 or (800) 605-4327. You may also obtain a free copy by sending a stamped, self-addressed business envelope to Power of Attorney, Division of Public Health, P.O. Box 309, Madison, WI 53701. Copies may also be obtained at the Wisconsin Department of Health Services website.

GHC-SCW does not discriminate on the basis of disability in the provision of programs, services or activities. If you need this information interpreted or in an alternate format or language, or if you need assistance with any of our services, contact the GHC-SCW Member Services Department at (608) 828-4853 or (800) 605-4327.

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