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.
Progress Visit Notes (PVN) - 1440
Progress Visit Notes (PVN) - 1002
Employer Pay Authorization - 1440
Employer Pay Authorization - 1002
Attendance Incident Report - 1440
Attendance Incident Report - 1002
2nd Quarter Employer Pay Authorization Packet - 1440