MI-POST Form MDHHS-5836: Michigan Scope of Treatment

MI-POST is Michigan's optional portable medical order for adults with advanced illness or frailty for whom, given their current condition, death would occur within one year. On a one-page, two-sided form, the attending professional and the patient or representative record CPR status, a treatment level (comfort-focused, selective or full) and any additional orders such as dialysis or artificial nutrition. It directs EMS care when the patient cannot speak for themselves.

Who completes it

A physician, nurse practitioner or physician assistant completes the orders in Part 2 and signs Section D after a goals-of-care discussion; forms signed by an NP or PA list the collaborating physician. The patient, patient advocate or court-appointed guardian signs Section E.

Submitting and payment

How to submit it
Nothing is filed with the state. The original belongs to the patient and goes with them on every transfer or discharge; paper copies, faxes and digital images are valid.

Good to know

  • The form is void if Part 1 or Section D is blank; a blank Section A, B or C is read as full treatment for that section.
  • Choosing Attempt CPR requires Full Treatment in Section B. Review the MDHHS-5837 information sheet with the patient before signing the order.
  • Verbal or telephone orders are accepted when marked as such on the form, but the attending professional must sign and date within 10 calendar days.
  • Reaffirm or revoke within a year of signing, and within 30 days of a change in attending professional, care setting or an unexpected change in condition.

Get the official form

Download the current version from the source each time; forms change without notice.

Michigan Physician Orders for Scope of Treatment (MI-POST)

Órdenes Médicas de Michigan para Alcance del Tratamiento (MI-POST)

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Who can sign a Michigan MI-POST?

A physician, nurse practitioner or physician assistant responsible for the patient's care signs as the attending health professional, and NP or PA forms must include the collaborating physician's name and phone. Nurses, social workers and chaplains may help with the conversation but cannot sign the order.

Does MI-POST expire?

Yes. It expires one year from completion unless reviewed and reaffirmed, which resets the timeline. If a form is revoked or not reaffirmed and no new one is completed, full treatment and resuscitation are provided.

Is MI-POST available in Spanish?

Yes. MDHHS posts the MI-POST form and the MDHHS-5837 Patient and Family Information Sheet in English, Spanish (MDHHS-5836-SP) and Arabic (MDHHS-5836-AR). The Spanish edition is bilingual, with English and Spanish on the same form.