Power of AttorneyForms & guidance
Find a form ↗

Michigan Medical Power of Attorney: Patient Advocate Form

The patient advocate acts when the patient cannot participate in the relevant decisions; the form distinguishes medical from mental-health capacity determinations.

Jurisdiction
Michigan
Purpose
Medical & health care
Source / form version
Undated visible edition; current linked PDF downloaded as 13 pages
Resource format
PDF
Signing
Sign and date with two eligible witnesses. The patient advocate signs the acceptance before acting; notarization does not replace the two witnesses.
Preview PDF

Open the preview to load the complete document. If it does not display, use the direct link below.

Open PDF in a new tab (opens in a new tab)

Sources checked: 2026-11-13. General information, not individual legal advice.

Appoint a patient advocate

Michigan uses the patient-advocate designation for medical and mental-health decisions. The Kimble Center’s thirteen-page file includes a cover, personal choices, witness statements and agent acceptance. Name backups and discuss the responsibility with them. The final acceptance pages belong with the appointment; naming someone alone does not complete their acceptance.

Sources: [2] [3] [4]

Review optional mental-health choices

The form has separate treatment preferences and an optional mental-health section. That section includes a delayed-revocation choice that can keep authority in place for a period after attempted cancellation during mental-health care. Read that election carefully rather than checking every optional item. The form also separates organ-donation instructions from routine treatment authority.

Sources: [2] [3] [4]

Arrange two qualified witnesses

MCL 700.5506 excludes specified relatives, heirs, the patient advocate, physicians and certain care or insurance employees from witnessing. Both witnesses must sign. The designation belongs in the medical record before implementation. Medical decisions and mental-health decisions use different professional findings under the form; a financial power does not replace this appointment. Keep the patient’s treatment choices attached to the advocate’s appointment and acceptance. A detached appointment page may fail to communicate the limits the patient intended.

Sources: [2] [3] [4]

Common questions

Does notarization replace the witnesses?

No. This patient-advocate form uses two eligible witnesses under MCL 700.5506.

Sources: [2] [3] [4]

Must the advocate sign?

The form includes acceptance statements for the advocate and backups. Have each person read and complete the applicable acceptance before relying on the appointment.

Sources: [2] [3] [4]

Related forms and guides

Sources and verification

  1. Kimble Center for Legal Drafting, Cooley Law School; linked by Michigan Attorney General: source and instructions (opens in a new tab)
  2. Published form (opens in a new tab)
  3. MCL 700.5506, designation and witnesses (opens in a new tab)
  4. MCL 700.5507, advocate acceptance (opens in a new tab)

13-page PDF downloaded and text inspected, AcroForm fields detected. Metadata creation May 2026 is not represented as a printed edition date.

The date above records a source check. It does not certify that a form is suitable for your circumstances or that an attorney has reviewed your document. Read the publisher’s current instructions before use.