12860 attorney 2026

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The document is a Power of Attorney for Healthcare form designed for residents of Wisconsin, Minnesota, and Iowa. It allows individuals to appoint a healthcare agent to make medical decisions on their behalf if they become unable to do so. The document outlines the authority granted to the agent, instructions for completing the form, and emphasizes the importance of discussing healthcare preferences with the appointed agent. It includes sections for specifying desires regarding medical treatment, organ donation, and legal formalities required for validation.

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Click ‘Get Form’ to open the 12860 attorney document in the editor.
Begin by providing your personal information on page 1, including your name, date of birth, and address.
On page 3, appoint at least one healthcare agent by filling in their details. Ensure this person understands your values and is willing to advocate for you.
Proceed to page 5 and indicate your choices for sections regarding authority over nursing home admission, withdrawal of life-sustaining treatment, and decisions during pregnancy. Initial next to your selections.
In Part III, provide any specific instructions or limitations you want your healthcare agent to follow. If none, simply write 'no instructions' across the page.
Sign and date the document on page 10 in the presence of two witnesses or a notary public as required by your state.

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