Texas Medical Power of Attorney (POA) Form

The Medical Power of Attorney (MPA) is a document that allows a person to choose a reliable agent or attorney who will act in critical conditions and situations of crisis. If a person (or a declarant) becomes disabled and unconscious or suddenly faces a vegetative state, coma, or a similar physical condition, the agent appointed by MPA will take care of the decisions regarding the declarant.

The agent or attorney will be responsible for continuing or stopping the treatment, accepting or refusing it for the declarant. This is a vital document in the United States, especially for the people that have already gotten sick and have severe disease or those who are older than a certain age. Also, the medical power of attorney form lets the agent or attorney act in case of an accident when the victim has had serious injuries and has become disabled.

Texas power of attorney forms – discover more about powers of attorney used for different things in the State of Texas.

In the MPA form, you will leave special instructions that depend on your will. These instructions may tell about:

  • Medical care in general
  • Preferred treatment
  • Live-sustaining procedures

And other things tied to your health care in critical conditions.

Every state in the US has different rules and laws regarding the MPA form. In some states, you will need to notarize the form. Others ask for a witness or two witnesses to make the form valid.

Texas Laws and Requirements

As stated in section § 166.154 (a) of the Texas state law, signing a form should be accompanied by two witnesses. You should be over 18 (or under this age but have the rights of an adult) and in sound mind. According to § 166.154(c), if you are not able to sign, your physician can do it for you in front of two witnesses.

You are to choose the future agent very carefully because one will make medical decisions for you. An agent can be any adult except for one from the medical staff of the hospital where you get treatment. But if at the same time one is your relative, then one can be.

Under Texas law (§ 166.154(c)), the signatures of you and other people involved may be in written or electronic form. After the signing process, an agent gets access to all your medical records for understanding what the right decision one must make on your behalf.

In Texas, you (as a declarant) may add three agents (principal and additional ones) in your health advance directive form. Do not forget to state the type of relationship that connects you with your agent (or agents).

The authors of the form recommend making a sufficient number of copies of your directive: give it to the agent, to your personal physician (if applicable), and to other people that might need it. From time to time, you may re-read your AD and create a new paper if your wish becomes different.

The form is simple and contains only four pages.

Filling Out the Form

We have prepared a detailed guide with all the required steps so you can easily complete the health care advance directive form in Texas. You may see this guide below.

1. Download the Template

To start, you need to download the template of the health care advance directive form. To make it simple, use our form building software.

2. Add Your Data

On the first line of the form, you, as a declarant, should place your full legal name.
Data adding section of a Texas medical power of attorney template

3. Choose Your Agent

After you have placed your personal details, proceed to the next section. Add the name of your agent, his or her best phone number, and home address.
Agent choosing part of medical power of attorney document for Texas

4. Add Special Conditions

In the blank field of the next section, you are to specify some instructions that can limit the responsibilities of your agent.
Special conditions adding part of Texas medical poa template

5. Add Additional Agent (If Needed)

In Texas, you may appoint two additional agents in your form. Below the limitations for your initially chosen agent, add the information about other agents (full legal names, actual home addresses, and telephone numbers). This is needed because sometimes your initial agent may also become unavailable or unable to act in accordance with your MDPA form.
Additional agent adding section of medical power of attorney for Texas  

6. Insert the Information about the People who Get Copies

In this section, you are to give information about the people who get copies of your MDPA. You should specify their full legal names and their places of residence.
Part for information about people with copies of a Texas mpoa

7. Choose the Effective Date (If Needed)

Here, you should choose the effective date of your DPA form. In Michigan, you may opt for the form effectiveness from the moment of signing or from the day when your physician determines your incapability.
Effective date choosing part of Texas medical poa

8. Study the Information

Below, you can see a text that contains the main information that concerns MDPA and transferring special rights to the agent. As a principal, you have to read them thoroughly and accept them. If something is still not clear, you may consult your lawyer.
Information studying part of Texas dpa form

9.  Sign the MDPA Form

You, as a declarant, must check the information you have provided several times and then sign the document. You should also add the actual date, the city, and the state where the procedure takes place. After it, you are to sign the document. If you are physically unable to do it, appoint a representative to sign the paper on your behalf.
Signing section of a mdpa form for Texas

10. Ask a Notary to Sign

This is a section for a notary to sign. The notarization makes the document gain more legal force. A notary should verify the document by signing, adding a signing date, state and county (where the procedure takes place), one’s full legal name, the date when commission expires, and putting a seal (if applicable).
Notary signing part of Texas medical poa form

11. Ask Two Witnesses to Sign

Two witnesses should sign, add the relevant data, singing dates, and their places of residence. Remember that none of your witnesses can act as your agent.
Witnesses signing section of Texas mpoa

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Published: Nov 20, 2020