Texas Medical Power of Attorney: Form and Signing Rules

A medical power of attorney is one of the core health care documents in Texas estate planning. It applies only while you are incapacitated, and it governs medical choices rather than money or property. What follows is what the document does, who may act as your agent, the signing rules that make it valid, and how to change or revoke it.

What a Texas medical power of attorney does

A medical power of attorney lets you appoint an agent, also called a health care agent, to speak for you when you cannot speak for yourself. Under Tex. Health & Safety Code § 166.152, the agent may make any health care decision you could make if you were competent, subject to any limits you write into the document.

The authority is not immediate. The agent can act only after your attending physician certifies in writing, and files the certification in your medical record, that you are incompetent to make health care decisions. While you can still decide for yourself, your decisions control, and treatment cannot be given or withheld over your objection no matter what the document says.

Even after the document becomes active, some decisions stay off limits. Your agent cannot consent to voluntary inpatient mental health services, convulsive treatment, psychosurgery, or abortion, and cannot direct the omission of care meant to keep you comfortable. These limits are fixed by the statutory form at Tex. Health & Safety Code § 166.164 and apply no matter how the form is worded.

Who can serve as your agent

Your agent must be an adult. The person you name has to be 18 or older, or a minor who has had the disabilities of minority removed, a requirement stated in the statutory form at § 166.164.

Texas also keeps certain people from acting for you because of a conflict of interest. Under Tex. Health & Safety Code § 166.153, a person cannot exercise an agent’s authority while serving as your health care provider, an employee of your health care provider, your residential care provider, or an employee of that provider. A relative is exempt from the two employee restrictions, so an adult child who happens to work at your nursing facility can still serve as your agent.

How to sign the form so it is valid

Texas publishes the exact wording of the document in § 166.164, which requires the form to be “substantially” in that statutory format. The current version reflects changes the Legislature made in House Bill 995 (2017), which revised the form and revocation rules effective in 2018.

Signing is where most defective documents fail. Tex. Health & Safety Code § 166.154 gives you two ways to execute the form, and you use one or the other.

1. Complete the form and name your agent

   Fill in your name and the name, address, and phone number of the agent. You can also name one or more alternate agents, who act in the order listed if your first choice is unable or unwilling to serve.

2. Write in any limits

   The form has a space to restrict your agent’s authority. Anything you leave unrestricted is authority the agent will have.

3. Choose a notary or two witnesses

   Sign before a notary public, or sign in the presence of two competent adult witnesses who then sign the form themselves. Only one method is required under § 166.154.

4. Check that your witnesses qualify

   If you use witnesses, neither one can be your agent, a relative by blood or marriage, someone entitled to your estate, your attending physician or that physician’s employee, or a facility employee who provides your direct care.

5. Distribute signed copies

   Give a signed copy to your agent and to your physician, and note on the form where the original is kept and who else holds copies.

The document is a private one. You do not file it with any court, and no state agency has to approve it before it works.

When it takes effect and how long it lasts

The trigger is medical, not calendar based. Your agent’s authority begins only when your attending physician certifies that you lack the competence to make health care decisions, under § 166.152. Before that point the document sits dormant, and you keep making your own choices.

Once signed, the document lasts indefinitely. § 166.152 provides that it exists from the date you execute it until you revoke it or regain competence, with no automatic expiration. If you write in an end date but are still incompetent when that date arrives, your agent’s authority continues until you can make decisions again.

How to change or revoke it

You can revoke a Texas medical power of attorney at any time, and your mental state does not matter. Tex. Health & Safety Code § 166.155 lets you revoke it orally or in writing by notifying your agent or a health or residential care provider, or by any act that shows you intend to revoke it. Signing a later medical power of attorney also cancels an earlier one.

Divorce changes the document by operation of law. If you named your spouse as agent and your marriage is later dissolved, annulled, or declared void, that appointment is revoked unless the document says otherwise, again under § 166.155. A provider who learns of a revocation must record it in your medical record and notify your agent and current providers.

The form cannot be edited after it is signed. The statutory language states that the document may not be changed or modified, so executing a new medical power of attorney is the way to make changes.

How it differs from other Texas health care documents

A medical power of attorney names a decision-maker. A directive to physicians, the Texas version of a living will, instead records your own wishes about life-sustaining treatment if you have a terminal or irreversible condition; its form is in Tex. Health & Safety Code § 166.033. Many people sign both, so that someone is named to decide and their instructions are also on record.

A medical power of attorney is also separate from a durable power of attorney. A durable power of attorney handles financial and property matters and is governed by the Texas Estates Code, not Chapter 166. One does not cover the other, so a person managing your bank accounts under a financial power of attorney has no authority over your medical care unless a medical power of attorney grants it.

Without any of these documents in place, Texas law lets certain family members act as surrogate decision-makers in some medical settings, and in others a court may have to appoint a guardian before anyone can act.