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Free Michigan Medical Power of Attorney Forms

Create a Michigan-compliant patient advocate designation to appoint a trusted patient advocate. Includes HIPAA authorization, end-of-life preferences, and all provisions required under MCL § 700.5506.

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Michigan Patient Advocate Designation
PDFWord
Michigan-compliant
Page 1 of 5
SG

Written by

Stefan Gol
AH

Fact-checked by

Anderson Hill
JD

Legally reviewed by

John Doe

Last updated March 2, 2026

Michigan Patient Advocate Designation Overview

In Michigan, a patient advocate designation is governed by MCL § 700.5506. This legal document allows you to designate a patient advocate who can make medical decisions on your behalf if you become unable to make or communicate those decisions yourself. Michigan law ensures that your patient advocate has the authority to work with healthcare providers to carry out your wishes regarding medical treatment.

Your patient advocate can make decisions about medical treatments, surgeries, medications, hospital stays, end-of-life care, and access to your medical records. The patient advocate designation typically takes effect only when a physician determines that you are unable to make decisions for yourself, though Michigan law may allow you to make it effective immediately if you prefer.

Creating a patient advocate designation in Michigan requires 2 witnesses and notarization is required. While Michigan does not mandate a specific form, the document must meet all requirements under MCL § 700.5506.

No

Statutory form required

2

Witnesses required

Required

Notarization

Yes

HIPAA included

Michigan Requirements

To create a valid patient advocate designation in Michigan, you must meet the following requirements under MCL § 700.5506:

Important: Michigan Execution Requirements

Michigan requires 2 witnesses for a valid patient advocate designation. The document must also be notarized. Witnesses cannot include your designated patient advocate or your treating healthcare provider.

  • Legal Age: You must be at least 18 years old and mentally competent at the time of signing
  • Witnesses: Michigan requires 2 witnesses who are not the patient advocate or healthcare provider
  • Notarization: Required in Michigan
  • Agent Designation: Name a primary patient advocate and optionally an alternate
  • HIPAA Authorization: Included in statutory form

How to Create Your Michigan Patient Advocate Designation

Follow these steps to create a valid patient advocate designation that complies with Michigan law.

1

Choose Your Patient Advocate

Select a trusted individual to serve as your patient advocate in Michigan. This person should understand your healthcare values, be willing to advocate on your behalf, and be available in case of emergency. Consider naming an alternate patient advocate as well.

2

Specify Your Healthcare Wishes

Document your preferences regarding medical treatments, end-of-life care, organ donation, DNR orders, and mental health treatment. Be as specific as possible about what treatments you do and do not want under various circumstances.

3

Include HIPAA Authorization

Add HIPAA authorization to ensure your patient advocate can access your medical records and communicate with your healthcare providers in Michigan. Without this, providers may legally refuse to share your medical information.

4

Sign with Witnesses and Notarize

Execute the document with 2 witnesses as required by Michigan law. You must also have the document notarized. Distribute copies to your patient advocate, physicians, hospital, and family members.

Choosing Your Michigan Patient Advocate

In Michigan, your patient advocate will have significant authority over your medical care. Choose someone who understands your values and can make difficult decisions under pressure.

  • Trustworthy: Someone who will follow your wishes, not impose their own preferences
  • Accessible: Someone who can be reached quickly and can travel to Michigan if needed
  • Assertive: Someone who can communicate effectively with medical professionals
  • Emotionally capable: Someone who can handle the stress of making life-or-death decisions

Sample Michigan Patient Advocate Designation

Below is a preview of our Michigan-specific patient advocate designation template.

STATE OF MICHIGAN

PATIENT ADVOCATE DESIGNATION

MCL § 700.5506

PRINCIPAL (You):

Name: [Your Name]
Address: [Michigan Address]

PATIENT ADVOCATE:

Name: [Agent Name]
Relationship: [Relationship]
Phone: [Phone]

Michigan Patient Advocate Designation FAQ

Answers to common questions about Michigan patient advocate designation requirements and procedures.

Official Michigan Resources

Use these official resources to verify Michigan requirements and access government forms.

Create Your Michigan Patient Advocate Designation

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