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Or fax it to 1 866 894 3101.
Durable power of attorney for health care michigan form. This type of contract either comes into effect immediately and endure after the principal s incapacitation or only upon a physician declaring that the. Anyone else who might need to know about your health care decisions for example a spouse a nursing home or a hospital. It is my intent that the laws of the state of michigan govern all questions concerning its validity the construction of its provisions and its. This document is signed in the state of michigan.
During the many years of debate over this law right to life of michigan took a strong position in defense of patients rights. Michigan has two kinds of advance directives. General power of attorney if you need someone to represent your general financial interests but you do not want the power to continue beyond when you have the sound mind to revoke it you should use this form. Durable power of attorney for health care.
On this document you will put what you want the doctors to do for every scenario you can think of. Advance directives in the state of michigan. The durable power of attorney for health care is about making decisions about your health care. Blue cross blue shield of michigan mail code 0400 600 e.
Durable power of attorney for health care form author. Adobe pdf ms word docx opendocument. 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. To change your durable power of attorney for health care fill out a.
Probably the easiest way to talk about this is to cover the basics. You can mail the form to us at. The michigan durable power of attorney form allows an individual known as the principal to choose a representative to make any type of financial decisions and actions on their behalf. One is the durable power of attorney for healthcare dpoa hc which can be used in both inpatient and ambulatory care settings within the university of michigan hospitals and health centers.
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