Self-direction forms that simplify your journey to independence
In self-direction, both Participants and Direct Care Professionals have responsibilities in managing the relationship and making it a positive experience. Our job is to make it simpler and easier for both of you. On this page, you’ll find forms that Participants and Direct Care Professionals will need to manage their relationship and comply with requirements and regulations. To explore programs for each of Michigan’s Medicaid self-direction programs, view the Medicaid Programs page on the MDHHS website.
Form SS4 - Application for Employer Identification Number
Form 8822 - Change of Address or Responsible Party-Business
Form 8821 - Tax Information Authorization
Form 2848 - Power of Attorney and Declaration of Representative
Form 2678 - Employer-Payer Appointment of Agent
Form 1488 - MI Power of Attorney
Form 518 - Registration for Michigan Taxes
Form 151 - Authorized Representative Declaration (Power of Attorney)