A healthcare directive is read by hospital staff under time pressure, and the signature and witness block is the first thing they check. Here is exactly what Michigan requires when you sign a healthcare directive, and how to run the signing so it holds up.
What Michigan requires
Michigan law calls for two witnesses when a healthcare directive is signed, and notarization is not required.
Witnesses watch you sign (or hear you acknowledge the signature as yours) and then sign themselves, so everyone must be present at the same time.
Statutory detail: Michigan uses a Designation of Patient Advocate, not a health care power of attorney. MCL 700.5506 requires the designation to be in writing, signed, witnessed, dated, and voluntary, and requires it to be made part of the patient's medical record before implementation. It must be executed in the presence of and signed by two witnesses; there is no notary-only route. A witness may not be the patient's spouse, parent, child, grandchild, sibling, presumptive heir, known devisee at the time of witnessing, physician, or patient advocate, and may not be an employee of a life or health insurance provider for the patient, of a health facility treating the patient, of a home for the aged where the patient resides, or of a community mental health services program or hospital providing mental health services to the patient. A witness may not sign unless the patient appears to be of sound mind and under no duress, fraud, or undue influence. Separately, MCL 700.5507(4) requires a copy of the designation to be given to the proposed patient advocate before implementation, and to a successor before the successor acts, AND requires the proposed advocate to sign an acceptance of the designation before acting as patient advocate. Both rules live in subsection (4) as amended by 2024 PA 1. MCL 700.5507(5) prescribes ten statements the acceptance must substantially include, among them that the designation cannot be used to withhold or withdraw treatment from a pregnant patient where that would result in her death.
- Witnesses: 2
- Notary: not required
Step-by-step signing checklist
Follow the steps in order, and sign nothing until everyone who needs to be present is in the room.
- Print and review the final PDF: Print the final version single-sided and read every page. Confirm the names, dates, and the people you appointed before anyone signs — a correction after signing means re-signing.
- Arrange two witnesses: Ask two witnesses to be with you at the same time and place. Choose adults who receive nothing under the document, and ask each to bring photo ID.
- Sign in front of everyone: Sign and date where the healthcare directive indicates, with two witnesses watching. Do not sign ahead of time.
- Have the witnesses sign: Each witness signs the attestation section while you and the other witness watch, then prints their name and address by hand.
- Store the original and hand out copies: Keep the signed original somewhere safe and fireproof, tell the people you appointed where it is, and give them copies. Never write changes on the signed original — sign a corrected version instead.
Mistakes that undo a valid document
Most signing failures are procedural, not substantive — the document was fine and the ceremony was not.
- Signing before the witnesses or notary arrive, then asking them to sign later.
- Witnesses who sign at different times or out of each other's sight.
- Using someone who benefits under the document as a witness — it invites a challenge and, in some states, costs them their gift.
- Skipping a page, an initial line, or the date.
- Writing changes by hand on the signed original.
- Losing the original; a photocopy is often not enough.
After signing
The original is the document. Store it where it will survive a fire and a move, and make sure the people you appointed can find it without you.
Revisit the healthcare directive when your family, your finances, or the people you appointed change. A new version is signed the same way; the old one should be destroyed once the new one is complete.
Frequently Asked Questions
How many witnesses does a Michigan healthcare directive need?
Two. They must be present at the same time, watching you sign or hearing you acknowledge the signature, before they sign themselves.
Does a Michigan healthcare directive have to be notarized?
No. Notarization is not required, though there is a statutory detail worth knowing: Michigan uses a Designation of Patient Advocate, not a health care power of attorney. MCL 700.5506 requires the designation to be in writing, signed, witnessed, dated, and voluntary, and requires it to be made part of the patient's medical record before implementation. It must be executed in the presence of and signed by two witnesses; there is no notary-only route. A witness may not be the patient's spouse, parent, child, grandchild, sibling, presumptive heir, known devisee at the time of witnessing, physician, or patient advocate, and may not be an employee of a life or health insurance provider for the patient, of a health facility treating the patient, of a home for the aged where the patient resides, or of a community mental health services program or hospital providing mental health services to the patient. A witness may not sign unless the patient appears to be of sound mind and under no duress, fraud, or undue influence. Separately, MCL 700.5507(4) requires a copy of the designation to be given to the proposed patient advocate before implementation, and to a successor before the successor acts, AND requires the proposed advocate to sign an acceptance of the designation before acting as patient advocate. Both rules live in subsection (4) as amended by 2024 PA 1. MCL 700.5507(5) prescribes ten statements the acceptance must substantially include, among them that the designation cannot be used to withhold or withdraw treatment from a pregnant patient where that would result in her death.
Do the witnesses need to read the document?
Generally no. A witness attests that you signed willingly and appeared to know what you were doing — not to the contents. They need to see you sign, or hear you say the signature is yours.
What should I do with the signed original?
Keep it somewhere safe and fireproof, tell the people you appointed exactly where it is, and give them copies. If anything needs to change later, sign a corrected version rather than marking up the original.