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Medical Power of Attorney in Texas: Forms, Witness Rules, and the Living Will
Texas splits advance planning into two documents: one names who decides for your parent, the other records what your parent wants.
By naveen · Updated · How we research our guides
What to know
- A Texas Medical Power of Attorney names an agent to make health care decisions; it must be signed before two qualified witnesses or acknowledged before a notary (Health and Safety Code §166.154).
- The agent can act only after your parent's attending physician certifies in writing that your parent is incompetent.
- Texas also has a Directive to Physicians and Family or Surrogates, listed by the state as its living will, which records treatment wishes.
- Texas Health and Human Services posts the official forms, and the Medical Power of Attorney must be "in substantially the following form" set out in the statute.
- Retirement Checklist puts these documents in order alongside everything else your family needs to settle.
A medical power of attorney in Texas is the document in which your parent names an agent to make health care decisions for them if they can't. Under Texas Health and Safety Code chapter 166, your parent signs it in front of two qualified witnesses or acknowledges it before a notary, and the agent's authority starts only when the attending physician certifies in writing that your parent is incompetent.
What is a medical power of attorney in Texas?
It's the document that names an agent to make your parent's health care decisions when your parent can't. Subject to any limits your parent writes in, "the agent may make any health care decision on the principal's behalf that the principal could make if the principal were competent" (§166.152). The agent speaks for your parent with doctors and hospitals once your parent can't speak for themselves.
It doesn't cover money. Texas handles finances with a separate document, the Statutory Durable Power of Attorney, which states that it "does not authorize anyone to make medical and other health-care decisions." See our guide to power of attorney in Texas for that side.
How is it different from a directive to physicians?
The Medical Power of Attorney names a person to decide, while the Directive to Physicians and Family or Surrogates, which the state's forms page labels its living will, records your parent's wishes about treatment.
| Medical Power of Attorney | Directive to Physicians and Family or Surrogates | |
|---|---|---|
| What it does | Names an agent to make health care decisions | Records your parent's treatment wishes |
| Form | Must be in substantially the statutory form (§166.164) | May follow the statutory form (§166.033) |
| Signing | Two qualified witnesses, or a notary (§166.154) | Two qualified witnesses, or a notary (§166.032) |
| Revoking | Notice to the agent or a provider, or a later MPOA (§166.155) | Destroying it, a signed revocation, or saying so (§166.042) |
A directive can also name someone to make treatment decisions (§166.032), but the Medical Power of Attorney is the document built for that job. For how these documents relate in general, see our guide to advance directives, living wills and medical power of attorney.
How do you sign a medical power of attorney in Texas?
Your parent either signs it before two qualified witnesses or has the signature acknowledged before a notary (§166.154):
- Sign it in the presence of two witnesses who qualify under §166.003, at least one of whom meets the stricter test in §166.003(2). The witnesses sign too.
- Sign it and have the signature acknowledged before a notary public, in place of witnesses.
If your parent is physically unable to sign, another person may sign the Medical Power of Attorney with your parent's name "in the principal's presence and at the principal's express direction" (§166.154(c)). The Directive to Physicians follows the same two-witness-or-notary rule (§166.032).
Who can't be a witness in Texas?
Any competent adult can witness, but at least one of the two witnesses must be someone who is not:
- the person your parent names to make treatment decisions;
- related to your parent by blood or marriage;
- entitled to any part of your parent's estate after death;
- your parent's attending physician, or an employee of that physician;
- an employee of a facility where your parent is a patient who provides their direct care, or an officer, director, partner or business office employee of the facility or its parent organization;
- someone with a claim against any part of your parent's estate.
That list comes from §166.003. So a relative can be one witness if the other witness clears every item on it.
Who can't serve as the agent?
A person can't act as agent while serving as your parent's health care provider or residential care provider, or as an employee of either, "unless the person is a relative of the principal" (§166.153). So a relative who works for your parent's health care provider can still serve; an unrelated employee can't.
When does the agent start making decisions?
Only after a physician's written certification. "An agent may exercise authority only if the principal's attending physician certifies in writing and files the certification in the principal's medical record that, based on the attending physician's reasonable medical judgment, the principal is incompetent" (§166.152). Until then, your parent makes their own decisions.
Your parent's objection also matters afterward. Treatment may not be given to or withheld from your parent if they object, whether or not a medical power of attorney is in effect and whether or not they're competent at the time (§166.152(c)).
Because the agent has no authority before that certification, talking with your parent's doctors sooner takes something else; see our guide to HIPAA authorization.
Where do you get the official Texas forms?
Texas Health and Human Services lists the state's advance directive forms on its forms page:
- Medical Power of Attorney Designation of Health Care Agent (effective May 2024, English and Spanish PDFs)
- Directive to Physicians and Family or Surrogates (Living Will)
- Out-of-Hospital Do-Not-Resuscitate Order
- Declaration for Mental Health Treatment
- Statutory Durable Power of Attorney, for finances
The Medical Power of Attorney "must be in substantially the following form" (§166.164), and the statute prints that form in full. The directive "may be in the following form" (§166.033), which leaves more room.
What happens if your parent has no advance directive?
Texas has a narrow fallback: for a qualified patient, the attending physician makes a treatment decision with a guardian, an agent or a relative in a set order (§166.039). Section 166.039 covers a "qualified patient", which the statute defines as a patient with a terminal or irreversible condition diagnosed and certified in writing by the attending physician. For that patient, if there's no directive and they can't communicate, the attending physician and the patient's legal guardian or medical power of attorney agent may make a treatment decision. If there's no guardian or agent, the physician and one available person from this list, in this order, may decide:
- your parent's spouse;
- your parent's reasonably available adult children;
- your parent's parents;
- your parent's nearest living relative.
The decision "must be based on knowledge of what the patient would desire, if known." A medical power of attorney lets your parent choose the person instead of the statute, and it isn't limited to those conditions.
How do you revoke a Texas advance directive?
Your parent can revoke either document, and the methods below, other than signing a newer Medical Power of Attorney, work regardless of your parent's mental state at the time (§§166.042, 166.155).
A Medical Power of Attorney is revoked by oral or written notice to the agent or a licensed health or residential care provider, by any act showing a specific intent to revoke, or by signing a newer one (§166.155). If the agent is your parent's spouse, divorce or annulment revokes that appointment unless the document says otherwise.
A directive can be revoked by destroying it, by a signed and dated written revocation, or by your parent saying they intend to revoke it (§166.042). A written revocation takes effect only once the attending physician is notified or it's mailed to them.
What questions are worth asking before your parent signs?
These questions are for your parent to answer; this guide doesn't suggest who to name or what to choose:
- Who would your parent trust to follow their wishes even when the family disagrees?
- Is that person reachable quickly, and willing to do it?
- Who should be the alternate if the first choice can't serve?
- Has your parent told their doctor which documents exist, and where they're kept?
- Does the agent know your parent's wishes in their own words?
Frequently asked questions
Does a medical power of attorney need to be notarized in Texas?
No, notarization is one of two options. Under Health and Safety Code §166.154, your parent can sign before two qualified witnesses, who also sign, or have the signature acknowledged before a notary public instead. If they choose a notary, the fee for an acknowledgment is capped at $10 for the first signature (Government Code §406.024).
Can a family member witness a medical power of attorney in Texas?
One can. Each witness must be a competent adult, and at least one must not be related to your parent by blood or marriage, not be the named agent, not stand to inherit, and not be the physician or certain facility staff. A relative can therefore serve as the other witness.
Where can I get the Texas medical power of attorney form?
Texas Health and Human Services posts the Medical Power of Attorney Designation of Health Care Agent form, effective May 2024, in English and Spanish on its advance directives forms page. Section 166.164 requires the document to be in substantially the statutory form, which is printed in the statute itself.
Does a Texas medical power of attorney cover finances?
No. It covers health care decisions only. Money and property are handled by a separate Statutory Durable Power of Attorney under the Estates Code, which must be acknowledged before a notary or other authorized officer and which states that it doesn't authorize anyone to make medical decisions.
Is an advance directive from another state valid in Texas?
Yes. Under §166.005, an advance directive validly executed in another state "shall be given the same effect as an advance directive validly executed under the law of this state." That section doesn't authorize any care Texas law otherwise prohibits, so a Texas provider applies it within Texas rules.
Can my parent change their mind after signing?
Yes, at any time, and Texas allows it regardless of your parent's competence. A medical power of attorney can be revoked by telling the agent or a provider, orally or in writing, or by signing a new one. A directive can be destroyed, revoked in writing, or revoked by saying so.
Getting started
These documents only help if they're signed while your parent can make the choice, and if the people who need them can find them. The plan this site builds asks four questions, including which state your parents live in, and puts the steps that matter most for your family in order. It's free and takes about 90 seconds.
Related guides
Sources
- Texas Health and Safety Code chapter 166, Advance Directives: witnesses, signing, forms, physician certification, the no-directive fallback, and revocation (§§166.003 to 166.164).
- Texas Health and Human Services, Advance Directives forms: the official Medical Power of Attorney, Directive to Physicians and related forms.
- Texas Government Code chapter 406, Notary Public: the fee a notary may charge for an acknowledgment (§406.024).
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