Michigan Patient Advocate Designation Template (Word + PDF)

Michigan’s official advance directive — name the person who decides when you can’t.

A Designation of Patient Advocate under MCL 700.5506–700.5515 names another adult to make care, custody, and medical treatment decisions when you cannot participate. Optional sections cover mental-health treatment and anatomical gifts. The template includes the patient advocate acceptance Michigan requires before the advocate can act.

What’s included

• Patient Advocate Designation template with successor advocate
• Life-sustaining treatment authority (clear-and-convincing statement)
• Optional mental-health and anatomical-gift authority
• Patient advocate acceptance form
• Witness blocks meeting MCL 700.5506 restrictions

Signing requirements in Michigan

Sign in front of two witnesses who are not your spouse, parent, child, grandchild, sibling, presumptive heir, physician, patient advocate, or an employee of your health facility or insurer. No notary is required.

Format and delivery

Fillable Word (.docx) template plus a print-ready PDF for the same document, delivered as an instant download after checkout. Every file includes plain-English completion instructions, a signing checklist, and a “common mistakes” list. Version 1.1 — legal research verified September 15, 2026.

Save with a kit

Included in the Michigan Essential Estate Documents Kit, the Healthcare Documents Trio, and the DPOA + Patient Advocate Kit.

Rexford Mercantile is not a law firm, and Jonathan and Ruth Rexford are not attorneys. This is a self-help legal template with general instructions — not legal advice, and no attorney–client relationship is created. You are responsible for confirming the form fits your situation and for signing, witnessing, and notarizing it as your state requires. Consult a licensed attorney in your state if your situation involves a blended family, a beneficiary with a disability, out-of-state property, a business, or a family dispute. Digital download with a 30-day satisfaction guarantee — see our Refund Policy. © 2026 Rexford Mercantile. Licensed for the purchaser’s personal use only; not for resale or redistribution.