A Michigan medical power of attorney is a written document in which you name another person to make care, custody, and medical or mental health treatment decisions for you. Michigan law calls it a patient advocate designation. It must be signed, dated, witnessed by two people and put in your medical record before use.[1] The free Michigan medical power of attorney form below includes an advance directive and downloads as a PDF.
Last Updated: October 2026. This guide is reviewed and updated regularly to reflect current Michigan law. If you notice an error or outdated information, please contact us.
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A Michigan medical power of attorney lets you name an adult you trust to make care, custody, and medical or mental health treatment decisions for you. Michigan law calls the person you name a patient advocate. [1] FormsPal calls that person your agent, and you are the principal. The powers are the ones written in the form you sign.
The FormsPal template is titled Michigan Medical Power of Attorney with Advance Directive. It combines the appointment of an agent with end-of-life wishes. For other documents, browse our Michigan power of attorney forms, or read how a medical power of attorney form works in general.
Michigan sets its rules for this document in Mich. Comp. Laws § 700.5506. The sections below cover who can make the document, who can serve, how it is signed and witnessed, and where it goes before it is used.[1]
An individual who is 18 or older and of sound mind when the designation is made may name another individual in writing. The person named must also be 18 or older. That person exercises powers concerning care, custody, and medical or mental health treatment decisions for you.[1]
Your designation may also give your patient advocate authority to make an anatomical gift of all or part of your body. If it does, the designation must include a statement that this authority remains exercisable after your death.[1]
The designation must be in writing, signed, dated and executed voluntarily. It must also be witnessed. Michigan requires it to be executed in the presence of two witnesses and signed by both.[1]
Some people cannot act as a witness. A witness may not be any of the following people.[1]
A witness also must not sign unless the patient appears to be of sound mind and under no duress, fraud, or undue influence.[1]
The template also has a notary acknowledgment on page 7. The rules cited on this page deal with witnesses, so this guide does not say whether a notary is required.
Before the designation is put into use, it must be made part of the patient’s medical record. The record is kept, as applicable, with the patient’s attending physician, the mental health professional providing treatment, or the facility where the patient is located. For mental health services it may be a community mental health services program or hospital.[1]
It is common practice to give your doctor a copy of the signed document as soon as it is complete. That is a practical tip, not a quoted rule. To end an appointment later, see our guide to revoking a power of attorney.
| Document Name | Michigan Medical Power of Attorney Form |
| Legal Term | Patient advocate designation[1] |
| FormsPal Template | Michigan Medical Power of Attorney with Advance Directive, nine pages |
| State Laws | Mich. Comp. Laws § 700.5506 |
| Signing Requirements | Signed and dated by you, and executed in the presence of two witnesses who also sign[1] |
| Who Can Be the Agent? | Another individual who is 18 or older[1] |
| Who Can’t Be the Witness? | Your spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, physician or patient advocate, and certain employees listed above[1] |
| Avg. Time to Fill Out | 8 minutes |
| # of Fillable Fields | 29 |
| Available Formats | Adobe PDF |
Popular Local Medical POA Forms
HCPOA documents are used in each state. Have a look at other printable MPOA forms frequently filled out by our users.
The FormsPal template has three parts, a signature page, a notary acknowledgment, an information page and a witness page. What each part says comes from the printed text of the form, not from the statute. Read all nine pages before you sign.
The advance directive is a serious statement about end-of-life care. If it does not match what you want, talk to a lawyer or your doctor before you sign. You can also compare it with our Michigan living will form.
The form has 29 fillable fields, on pages 1, 6, 7 and 9. The six steps below follow the form in order. Pages 2 to 5 and page 8 are printed text with no blanks, so read them before you sign. To fill in the downloaded PDF on screen, use our online PDF editor.
The screenshots under each step show the FormsPal Michigan medical power of attorney template filled with sample entries in blue, so you can see where each answer goes. The names, addresses, dates and amounts are examples only.
Filling in the blanks is only part of the job. The steps below cover what happens around the form, from getting the template to keeping copies. Michigan requires two eligible witnesses, so choose them before you sign.[1]
A witness cannot be the patient’s spouse, parent, child, grandchild, sibling, presumptive heir, known devisee, physician, or patient advocate. Certain employees of the patient’s insurer or care providers are also excluded.[1]
Two. Michigan requires the designation to be executed in the presence of two witnesses and signed by both.[1]
Another individual who is 18 years of age or older. You must be 18 or older and of sound mind when you make the designation.[1]
A witness must not sign unless the patient appears to be of sound mind and under no duress, fraud, or undue influence.[1]
Yes. Before it is put into use, the designation must be made part of the patient’s medical record with the attending physician, treating mental health professional, facility, or community mental health program or hospital, as applicable.[1]
You can download the Michigan medical power of attorney as a PDF with 29 fillable fields, or build the document online and print it. The template runs nine pages and includes the signature page, a notary acknowledgment and two witness blocks. Whichever way you get it, Michigan requires two witnesses, so line them up before you sign.[1]
General information, not legal or tax advice.
