This legal document authorizes a patient advocate to make decisions about medical treatments and where you get care.

It only applies to health care. Patient advocates can’t make decisions about your financial or legal affairs.

To establish durable power of attorney for health care, you must be:

  • At least 18 years old
  • Legally competent

You don't need a lawyer present. Just follow these steps. You don’t have to use our forms, either.

If you have questions, you may want to talk to an attorney who specializes in probate or elder law.

Step 1: Choose your patient advocate. The person should be someone you trust to make decisions about your health care.

Step 2: Ask your patient advocate to accept their rights and responsibilities by signing the Acceptance by Patient Advocate (PDF).

Step 3: Fill out the Durable Power of Attorney for Health Care (PDF) form. You, your patient advocate and two witnesses need to sign it. Be sure to read about who can be a witness before signing.

Step 4: Give a copy of your durable power of attorney for health care to:

  • Your doctor, who’ll make it part of your medical records
  • Your patient advocate
  • Your lawyer
  • Anyone else who might need to know about your health care decisions—for example, a spouse, a nursing home or a hospital

You can mail the form to us at:

Blue Cross Blue Shield of Michigan
Mail Code 0400
600 E. Lafayette Blvd.
Detroit, MI 48226

Or fax it to 1-866-894-3101.

To change your durable power of attorney for health care, fill out a new form.

You can remove your patient advocate simply by making your wishes clearly known. They don’t have to be in writing. You can appoint another by repeating the steps above.