A medical power of attorney names the person who will make health care decisions for you if you cannot make them yourself. In Texas, the law sets out the form word for word, says exactly who may witness it, and lists decisions your agent can never make. Get one of those details wrong and a hospital may not accept the document when your family needs it.
This page sets out what Chapter 166 of the Texas Health and Safety Code requires, quoting the statute, and gives you the official Texas form as a free PDF and Word download.
The short answer
Texas has a statutory form: the medical power of attorney “must be in substantially the following form” set out in section 166.164. You sign it either with your signature acknowledged before a notary public, or in the presence of two competent adult witnesses, at least one of whom is not a relative, heir, your doctor or certain health care staff. Your agent can act only after your attending physician certifies in writing that you are incompetent.
How to sign a Texas medical power of attorney
Section 166.154 gives you two ways to sign. You choose one, not both:
| Option | What the statute requires |
|---|---|
| Notary | You sign “and have the signature acknowledged before a notary public” (166.154(b)). No witnesses needed. |
| Two witnesses | You sign “in the presence of two witnesses”, and “the witnesses must sign the document” (166.154(a)). Each must be a competent adult, and at least one must meet the stricter rules below. |
| You are physically unable to sign | Another person may sign your name “in the principal’s presence and at the principal’s express direction” (166.154(c)). |
Who cannot be your witness
If you use witnesses, at least one of them must be a person who is not any of the following (section 166.003). The official form prints the same list and asks the first witness to sign a statement confirming it.
- The person you name as your agent.
- A person related to you by blood or marriage.
- A person entitled to part of your estate under your will or by law.
- Your attending physician or an employee of your attending physician.
- An employee of a health care facility where you are a patient, if the employee gives you direct care or is an officer, director, partner or business office employee of the facility.
- A person who has a claim against your estate after your death.
The second witness only has to be a competent adult. A notary avoids the whole question, which is why many people choose that route.
When your agent can act
Not from the day you sign. Under section 166.152(b), “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.” Until then, you make your own decisions. And treatment “may not be given to or withheld from the principal if the principal objects”, whether or not the medical power of attorney is in effect and even if you are no longer competent (166.152(c)).
Once in effect, your agent decides “according to the agent’s knowledge of the principal’s wishes, including the principal’s religious and moral beliefs”, or by your best interests if your wishes are unknown (166.152(e)). Once signed and delivered to your agent, the document lasts indefinitely unless you revoke it or set an end date; if you are still unable to decide on that date, it continues until you can (166.152(g)).
Decisions your agent can never make
Whatever you write in the form, section 166.152(f) says an agent may not consent to:
- voluntary inpatient mental health services;
- convulsive treatment (electroconvulsive therapy);
- psychosurgery;
- abortion; or
- neglect of the principal through the omission of care primarily intended to provide for the comfort of the principal.
Who can be your agent
The form’s disclosure statement says your agent “must be 18 years of age or older or a person under 18 years of age who has had the disabilities of minority removed”. Your health or residential care provider, or an employee of one who is not your relative, cannot act as your agent while they also care for you (section 166.153). You may name a first and a second alternate agent, who step in “in the following order” if your agent is unable or unwilling to act.
Changing or revoking it
- Revoke at any time. By oral or written notice to your agent or to a licensed or certified health or residential care provider, or by any act showing a specific intent to revoke, “without regard to whether the principal is competent” (166.155(a)(1)).
- Sign a new one. A later medical power of attorney revokes the earlier one (166.155(a)(2)).
- Divorce. If your agent is your spouse, the appointment is revoked when the marriage is dissolved, annulled or declared void, unless the document provides otherwise (166.155(a-1)).
- No edits. The form itself warns: “This document may not be changed or modified. If you want to make changes in this document, you must execute a new medical power of attorney.”
Medical power of attorney or directive to physicians?
They do different jobs. The medical power of attorney names a person to decide for you. A directive to physicians (often called a “living will”, also in Chapter 166) records your own wishes about life-sustaining treatment. Under section 166.002, both documents are advance directives. Many people sign both, so their agent has written instructions to follow.
Free Texas medical power of attorney form
Download the statutory form in PDF or Word. It reproduces section 166.164 word for word, including the disclosure statement, the notary acknowledgment and the two-witness option with the first witness’s statement. Fill it in by hand or in Word, then sign using one of the two methods.
After you sign, the form asks where the original is kept and who has signed copies. Give a copy to your agent (the statute makes it effective on execution and delivery to the agent), your alternates and your doctor, and keep the original where your agent can reach it.
Texas medical power of attorney: common questions
Does a Texas medical power of attorney have to be notarized?
No. You can have your signature acknowledged before a notary, or sign in the presence of two competent adult witnesses instead (166.154). One method is enough.
Can a family member be a witness?
One of the two witnesses can be. At least one witness must not be related to you by blood or marriage, and must not be your agent, an heir, your doctor or certain health care staff (166.003(2)).
When does a medical power of attorney take effect in Texas?
Your agent can act only after your attending physician certifies in writing, in your medical record, that you are incompetent (166.152(b)).
Does a Texas medical power of attorney expire?
Not unless you set an end date or revoke it. It “exists indefinitely from the date I execute this document”, in the words of the form.
Do I need a lawyer to complete it?
The form’s disclosure statement says: “You do not need a lawyer’s assistance to complete this document, but if there is anything in this document that you do not understand, you should ask a lawyer to explain it to you.”
Related
- Medical power of attorney template for other states
- Living will template
- Durable power of attorney for financial decisions
- Texas power of attorney: the statutory durable form for money and property
- Texas last will and testament
How this page was checked
Every rule and quotation comes from Chapter 166 of the Texas Health and Safety Code, read in full on the Texas Legislature’s official statutes site: sections 166.003, 166.152, 166.153, 166.154, 166.155 and 166.164. The downloadable form was compared word by word against section 166.164.
Last verified: October 2026. We do not advance this date without re-checking the sources. The Texas Legislature can amend Chapter 166: check the current statute before you sign.
LegalTemplateVault is not a law firm and does not provide legal advice. Compiled and edited by Daniel Mercer, editor of LegalTemplateVault. He is not an attorney, and neither is anyone else on this site: we compile primary sources and cite them so you can check them yourself.