Durable Power Of Attorney For Health Care Michigan Fillable

In this document you should give directions to the person you select as your spokesperson or health care agent or proxy about the full range of care you want.

Durable power of attorney for health care michigan fillable.

A durable power of attorney for health care also known as a health care proxy or a patient advocate designation is a. Blue cross blue shield of michigan mail code 0400 600 e. Or fax it to 1 866 894 3101. You can mail the form to us at.

Free printable medical health care power of attorney forms. In a health care power of attorney or health care proxy you select the family member or trusted friend you want to make health care decisions for you when you cannot. Anyone else who might need to know about your health care decisions for example a spouse a nursing home or a hospital. Questions and answers about advance directives.

To change your durable power of attorney for health care fill out a. Durable power of attorney for health care wp 11479 aug 0 durablepoahealthcare 0810 i of michigan name city hereby appoint patient advocate residing at patient advocate address as my attorney in fact herein called patient advocate with the following power to be exercised. Medical power of attorney allows a person to handle someone else s health care decisions only in the chance that he or she may not be able to think for themselves. Page 3 of 7 1 4 agent s obligation.

My agent shall make health care decisions for me in accordance with this power of attorney for health care any instructions i give in part 2 of this form and my other wishes to the extent known to my agent. Two 2 witnesses or notary acknowledgment. Michigan state long term care. The michigan medical power of attorney form is used to designate a patient advocate to make all health care decisions for the principal if they become incapacitated due to illness old age or injury.

The document is called a durable power of attorney for health care dpoa hc. The principal and their patient advocate should share similar values as to health care and the advocate should be able to comfortably fulfill the principal s requests when the time comes. Adobe pdf ms word docx opendocument signing requirements 700 5501. This power of attorney has effect only if i become unable to participate in treatment decisions.

During the many years of debate over this law right to life of michigan took a strong position in defense of patients rights. Get and sign durable power of attorney for health care michigan fillable 2010 2020 form making decisions regarding my care custody or medical treatment.