Michigan Patient Advocate Form: How to Designate Your Healthcare Decision-Maker

Without a signed patient advocate designation, a Michigan hospital facing an incapacitated patient will default to whatever the attending physician and the closest available next-of-kin decide together. That might align with your wishes — or it might not. The patient advocate form is the document that ensures someone you trust holds the legal authority to speak for you when you cannot speak for yourself.

Here is what the form does, how to execute it correctly, and where it ends.

What a Michigan Patient Advocate Is

Under the Estates and Protected Individuals Code (EPIC), specifically MCL 700.5506, a Patient Advocate is a person you formally designate to make healthcare decisions on your behalf if you become incapacitated. This is Michigan's version of a medical power of attorney — the terms are used interchangeably in practice, though Michigan statute uses "Patient Advocate" as the official designation.

The Patient Advocate can make decisions about your care, custody, and medical or mental health treatment. The scope can be broad (any healthcare decision) or narrow (specific to certain conditions), depending on how you draft the designation. Critically, you can explicitly authorize your Patient Advocate to withhold or withdraw life-sustaining treatment — or you can explicitly prohibit them from making that call. The form requires you to state your wishes on this point.

What the Patient Advocate cannot do: make decisions about property, finances, or any matter that is not directly related to your care. For financial authority, you need a separate Durable Power of Attorney for Finances.

The DCH-3916 Form

The Michigan Department of Health and Human Services provides a standardized Designation of Patient Advocate Form, numbered DCH-3916. This is the form most Michigan residents use, and it is accepted by hospitals, nursing facilities, and other care providers statewide.

You can download DCH-3916 directly from the MDHHS website. The form walks you through:

• Naming your Patient Advocate (and an alternate, in case your first choice is unavailable)
• Specifying the conditions under which the designation becomes effective (typically when your attending physician determines you lack capacity to make informed healthcare decisions)
• Stating your wishes for end-of-life care, including your position on life-sustaining treatment, artificial nutrition and hydration, and organ donation
• Signing the document

The DCH-3916 is a starting point, not a ceiling. Some people work with an attorney to draft a more detailed designation that addresses specific medical scenarios — particular diagnoses, long-term care preferences, or the management of mental health treatment alongside physical health. That level of specificity is optional but worth considering if your situation is complex.

Execution Requirements: What Makes the Form Legal

A patient advocate designation that is not properly executed is not legally enforceable in Michigan. The requirements are straightforward:

You must be:

• At least 18 years old
• Of sound mind at the time of signing

The document must:

• Be in writing
• Be dated
• Be signed voluntarily by you

Witnessing: Michigan requires two adult witnesses to observe your signature. The witnesses must be present simultaneously and must not be:

• Your patient advocate or alternate patient advocate
• Your spouse, parent, child, grandchild, or sibling
• An heir who would inherit from you under a will or intestate succession
• A physician involved in your care
• An employee of your life or health insurance provider
• An employee of a healthcare facility where you are a patient

These witness exclusions exist to prevent conflicts of interest. If a family member witnesses your signature, the form could be challenged. Use witnesses who are genuinely neutral — a neighbor, a friend, a colleague.

Notarization: The DCH-3916 does not require a notary public under Michigan law. Proper witnessing is sufficient. However, having a notary sign alongside the witnesses adds an additional layer of protection against future challenges, and many people choose to do both.

Activating the Patient Advocate's Authority

Signing the form does not immediately hand authority to your Patient Advocate. The designation becomes effective only when your attending physician determines in writing that you are unable to participate in your own medical decisions. Until that written determination is made, you retain full decision-making authority over your own care.

Once the physician's determination is documented, your Patient Advocate steps in. They are legally required to act in accordance with your known wishes and, if your wishes are not known, in your best interest. They cannot make decisions that contradict explicit written instructions you have provided.

The Critical Limitation: Authority Ends at Death

This is where many families are caught off guard. The Patient Advocate's authority terminates the moment you die. The DCH-3916 says nothing about funerals, burial, cremation, or the disposition of your body. Those decisions require a completely separate document.

Michigan enacted Public Act 57 of 2016, creating the Funeral Representative Designation under MCL 700.3206. This is the document that lets you name a specific person to control your funeral arrangements. Without it, Michigan's statutory hierarchy takes over — your surviving spouse, then adult children in birth order, then extended family. If multiple people share equal priority (three adult children, for example), they must reach a majority consensus, and if they cannot agree, the funeral home cannot proceed until the dispute is resolved — sometimes in probate court.

The Patient Advocate and the Funeral Representative can be the same person, but they must be named in two separate documents. Many estate planning attorneys draft both at the same appointment. If you are only completing one today, complete the patient advocate designation for medical decisions and plan to handle the funeral representative designation as soon as possible.

The Michigan Funeral Laws & Consumer Rights Guide covers the Funeral Representative Designation in detail, including the witness and notary requirements, who is legally barred from serving as your representative, and what happens to the 72-hour clock for exercising disposition rights if your designated representative cannot be located.

Where to Keep the Form and Who Should Have Copies

A patient advocate designation is useless if the hospital cannot find it when you are admitted unconscious. Standard practice is to:

• Give your original signed document to your Patient Advocate
• Provide certified copies to your primary care physician and any specialists you see regularly
• File a copy with any healthcare facility that treats you on an ongoing basis (dialysis centers, cancer treatment centers, etc.)
• Keep a copy in your home records and note its location in a document accessible to your household

Some people register their advance directives with the Michigan Health & Hospital Association's Advance Directive Registry. The registry is not legally required, but it gives hospital staff a place to check if you arrive without documentation.

Review the document every few years. Life circumstances change — your designated advocate may predecease you, move away, or your relationship may change. An outdated designation naming someone who is no longer the right choice can create complications that are entirely avoidable.

Combining the Patient Advocate Form with a Complete Plan

The patient advocate designation is one piece of a larger picture. A complete Michigan end-of-life planning structure typically includes:

• DCH-3916 Patient Advocate Designation — healthcare decisions during incapacity
• Michigan Funeral Representative Designation — funeral and burial decisions after death
• Durable Power of Attorney for Finances — financial decisions during incapacity
• Will or Trust — asset distribution after death
• Advance care planning conversation — making sure your Patient Advocate actually knows your wishes, not just has legal authority to act

The documents do different jobs. Having only one of them leaves gaps that default back to state law — and state law may not reflect what you would choose.

See more Michigan guides →