Medical Power of Attorney Texas Form


Texas Medical Power of Attorney Form is governed by the Section 166.033 of the Texas Health and Safety Code and its purpose is to appoint an agent to make healthcare decisions on your behalf in case you are incapacitated to do so. Please select a trustworthy agent as this legal instrument grants unopposed powers to the appointed agent to consent or refuse any and/or all medical treatments in the future. You may seek advice from competent authorities like your physician and/or lawyer to understand the scope of powers you are granting to your agent. This legal document has provisions to designate alternate agents. Your appointed agent by executing this medical power of attorney has equal powers of decision-making as if you are doing it.

Texas Medical Power of Attorney Facts

  • Execution of this Medical Power of Attorney in Texas State never refrains you from making your own healthcare decision.
  • This instrument is not amendable; however, you may choose to execute a new power of attorney to supersede this instrument.
  • Execution of this power of attorney stands legal only when you sign before a notary public of Texas State or two adult witnesses.
  • Please mention limitations of agent’s decision-making powers if any if you feel necessary.
  • You revoke all previously executed power of attorneys by signing this instrument before the notary public of Texas State or two adult witnesses.
  • More information on the laws of using a Medial Power of Attorney in Texas is specified in  Section 166.033 of the Texas Health and Safety Code.

Directions on Filling the Power of Attorney correctly

Step 1: Enter your name and then the agent’s name, address, and phone number. You may choose to furnish limitations to the powers if any in the space provided for the same.

Step 2: Use the space in case you wish to appoint an alternate agent. You may choose to appoint up to two alternate agents by entering the name, address, and phone number of each alternate agent. Then provide the address where this Texas Medical Power of Attorney original instrument is kept. Enter the names and addresses of institutions and/or individuals who possess a copy of this instrument.

Step 3: Please mention the date of natural termination of this medical power of attorney in Texas State in case you wish to terminate it on a specific date.

Step 4: Then get your signature acknowledged by a notary public of Texas State. Your printed name is necessary below your signature.

Step 5: You may choose to sign before two adult and competent witnesses to execute this document alternately. Please request both witnesses to sign and acknowledge the execution of Texas Medical Power of Attorney.

Revoking a Medical Power of Attorney in Texas



This Texas Medical Power of Attorney remains in force unless you mention the date of natural termination. Executing another medical power of attorney revokes this instrument. Alternately, you may choose to execute a revoke a power of attorney form to terminate the powers granted by executing this medical power of attorney. Divorce with spouse dissolves this instrument in case your spouse is designated as your agent.