Michigan Patient Advocate Form: How to Complete a Patient Advocate Designation

Your parent is heading into surgery, and the hospital just asked if they have a Patient Advocate Designation on file. They don't. You've heard of "medical power of attorney" and "health care proxy" — in Michigan, the legal instrument that covers this is called a Patient Advocate Designation (PAD), and it operates under very specific rules in MCL 700.5506 that are easy to get wrong.

What a Patient Advocate Designation Does

A PAD authorizes a named individual (the patient advocate) to make medical decisions on behalf of the patient when the patient can no longer communicate their own wishes. This includes:

• Consenting to or refusing medical treatment
• Choosing between care facilities
• Accessing medical records
• Making end-of-life decisions (including withdrawing life-sustaining treatment, if the PAD explicitly grants this authority)

The PAD only activates when the patient is unable to participate in medical decisions. Until that point, the patient retains full authority.

The Witness Rules That Trip Families Up

Michigan law imposes strict witness requirements that differ from many other states:

The PAD must be signed by the patient in the presence of two witnesses. At least one witness must be a disinterested party — someone who is NOT:

• The patient's spouse, parent, child, grandchild, or sibling
• The patient's presumptive heir or known beneficiary under a will
• The patient's physician or the physician's employee
• An employee of the health facility where the patient is receiving care
• An employee of the patient's life or health insurance provider
• The named patient advocate

The second witness can be a family member, but the first cannot. This requirement exists to prevent undue influence, and hospitals will reject a PAD where both witnesses are family members.

How to Fill Out the Form

Michigan does not have a single mandatory state form — any written document that meets the statutory requirements is valid. However, using a standardized template reduces the risk of rejection:

1. Patient Information: Full legal name, date of birth, address

2. Patient Advocate Designation: Name, address, and phone number of the person you're designating. Name a successor advocate in case the primary person is unavailable.

3. Scope of Authority: Specify whether the advocate can:

• Make all health care decisions, or only certain types
• Access mental health records (requires explicit authorization under Michigan law)
• Authorize withdrawal of life-sustaining treatment (this must be stated explicitly — without it, the advocate cannot make end-of-life decisions)

4. Signatures: The patient signs and dates the document. Both witnesses sign and print their names, confirming they witnessed the patient's signature and that the patient appeared to be of sound mind.

5. Notarization: Not legally required in Michigan, but some health care facilities and financial institutions give notarized documents more weight.

PAD vs Durable Financial Power of Attorney

A Patient Advocate Designation covers medical decisions only. It does not give anyone authority to manage your parent's bank accounts, pay bills, sell property, or handle Medicaid applications. For financial authority, your parent needs a separate Durable Financial Power of Attorney (DPOAH).

For aging-in-place planning in Michigan, you need both documents. The PAD lets you talk to doctors and make care decisions. The DPOAH lets you manage the Medicaid application, handle spend-down strategies, file the MI Choice Waiver paperwork, and execute legal tools like Lady Bird deeds.

What Happens If Your Parent Has Already Lost Capacity

If your parent has progressed into dementia or suffered a stroke that prevents them from understanding and signing a PAD, the document cannot be executed. At that point, the family must petition the local county Probate Court for guardianship (for medical decisions) and/or conservatorship (for financial decisions).

This process requires:

• Filing Form PC 625 (Petition for Appointment of Guardian)
• A physician's report (Form PC 630) confirming incapacity
• A court hearing scheduled 3–4 weeks after filing
• Filing fee: $175
• Possible appointment of a Guardian ad Litem ($75–$175)

The guardianship route is slower, more expensive, and public record. This is why elder care attorneys in Michigan emphasize executing the PAD and DPOAH early — while the parent still has capacity.

Where to File

Give copies of the completed PAD to:

• Your parent's primary care physician (ask them to scan it into the medical record)
• The designated patient advocate
• The hospital or health system your parent uses most frequently
• Keep the original in a safe, accessible location — not a safe deposit box, which may be inaccessible in an emergency

The Michigan Home Care, Waivers & Support Guide includes the full legal planning workflow — PAD, DPOAH, Lady Bird deeds, and when guardianship becomes necessary — with form references and filing instructions.

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