Medical Power of Attorney Texas 7
Medical Power of Attorney Texas 1
Medical Power of Attorney Texas 2
Medical Power of Attorney Texas 3
Medical Power of Attorney Texas 4
Medical Power of Attorney Texas 5
Medical Power of Attorney Texas 6
Medical Power of Attorney Texas 7
Medical Power of Attorney Texas 1

Medical Power of Attorney Texas

    Putting together a medical power of attorney is one of the most important things you can do to give someone legal authority to make medical decisions for you in Texas. Learn how to make this easy with our helpful, easy-to-read medical power of attorney Texas template. Written and approved by licensed attorneys, this convenient template will require little effort to understand and customize.

Download templateUse template
Medical Power of Attorney Texas
PDF Word

Medical Power of Attorney Texas

Fill & sign this document online

A power of attorney is a legal document where you can appoint and authorize a trusted person to make decisions for you under different circumstances.

There are different types of power of attorney, such as durable and non-durable, springing, financial, and medical. The basic principle of all these types of POAs are the same – they enable another trusted person known as an ‘agent’ to make decisions on your behalf.

But each of these POAs is different in some aspects such as what decisions you allow the agent to make and when and how the document comes into effect.

In this post, we’ll explain in detail the Texas medical power of attorney, such as what it is and how it works.

What is a Texas Medical Power of Attorney?

The medical power of attorney Texas is used to grant authority to an agent to make healthcare decisions for you when you are incapable of making the decisions yourself.

Healthcare decisions involve things such as choosing the proper course of treatment for your condition, accepting or denying certain treatment methods or medications, accessing your medical history, and even something as serious as choosing to end life-support.

The person that authorizes the agent to make decisions for him/her is called the ‘principal.’ By signing the medical power of attorney as a principal, you are essentially allowing the agent to make crucial decisions regarding your health and medical treatment that might even involve life and death situations.

That is why you must be extremely careful and selective about choosing the most trustworthy person – be it a family member, relative, or a close friend – as the agent.

Get a free copy of our medical power of attorney Texas template!

Our medical power of attorney Texas template is the perfect template for making medical PoA in Texas. You'll never have a problem drafting this type of document on your own with this form!

Click the buttons here to download a copy of this template!

Why and When Do You Need a Texas Medical Power of Attorney?

Generally speaking, you should have a medical power of attorney form Texas in place if you are suffering from a condition that is severe and will most likely leave you incapacitated or unable to make decisions for yourself in the future.

One of the most common use cases of medical power of attorney is for senior citizens and older people unable to look after their own health effectively in Texas.

But even if you’re young and not suffering from any severe medical conditions, you are still free to get a medical power of attorney in place to prepare for unforeseen health issues in the future. Yet it’s mainly old and aging people, disabled people, and those suffering from long-term medical conditions that need a Texas medical power of attorney.

What is the Importance of Medical Power of Attorney?

If sudden complications in your health leave you in a difficult state, such as incapacitated or in a coma, then it becomes very difficult and complicated to determine who should have a say in your treatment. Or, if you’re a senior citizen with deteriorating mental and cognitive skills, you might not be able to make the best healthcare decisions for your good.

In such cases, it’s important to have a trusted person, one that cares for your well-being as an agent. And as already mentioned before, there can be life and death situations due to health complications.

Without an agent to act on your behalf, precious time will be wasted in determining who should make decisions in such situations. Hence, the medical power of attorney can be extremely useful in crucial, time-sensitive medical conditions.

What Does a Texas Medical Power of Attorney Include?

The Texas Medical Power of Attorney allows your agent to make any decisions related to your healthcare and medical treatment. But there are some decisions that the agent cannot make such as:

  • Consent to neurosurgery and abortion
  • Denying treatment that is sure and certain to improve your health condition or provide temporary comfort

Also, keep in mind that your agent cannot be your doctor or the primary health care professional looking after your condition, nor can it be any other person employed by them.

The Texas medical power of attorney form requires the following details:

  • The names of both principal and agent, along with their addresses and contact number.
  • A box to specify if the principal wants to place any limitations on the decision-making authority of the agent.
  • Name and details of two alternate agents (in case the main agent is also rendered incapable of making decisions somehow). However, this field is not mandatory.
  • Statement and signature of two witnesses OR the signature from a notary
Get a free copy of our medical power of attorney Texas template!

Our medical power of attorney Texas template is the perfect template for making medical PoA in Texas. You'll never have a problem drafting this type of document on your own with this form!

Click the buttons here to download a copy of this template!

Other Key Factors You Should Know About Texas Medical Power of Attorney

Here are some minor, yet essential details about the medical power of attorney Texas form:

  • You can decide if a power of attorney comes into effect immediately after obtaining all signatures or in the future, only after you become incapable of making your own decisions.
  • You can set an expiration date for your power of attorney, after which it gets automatically revoked.
  • If you choose to get signatures of two witnesses, they must both be adults. One out of the two witnesses must be someone that is not:
  • the agents themselves; your doctor/medical care providers or their employees; your spouse or relative; any person who has some claim over your will or estate.

The Texas Medical Power of Attorney is essential if you are aging or suffering from a serious illness. But we do recommend that you choose your agent with extreme care and put a lot of thoughts into it. If you have decided to set up a medical power of attorney, you can easily download the required templates from CocoSign, where you’ll find hundreds of templates for all types of power of attorney forms.

DOCUMENT PREVIEW

MEDICAL POWER OF ATTORNEY 

IMPORTANT INFORMATION

 

IT IS IMPORTANT THAT YOU REVIEW THE FOLLOWING INFORMATION BEFORE YOU SIGN THIS DOCUMENT. READ THE INFORMATION CAREFULLY AND SEEK GUIDANCE FROM A HEALTHCARE PROFESSIONAL OR ATTORNEY IF YOU DO NOT UNDERSTAND ANY OF THE TERMS.

 

By signing this document, you are giving authority to the person you are designating as your agent to make medical decisions on your behalf. Medical decisions can include any medical service, treatment, medical procedure, diagnosis or treat both mental and physical conditions. Your agent will be able to act with the same authority you would have if you were able to act for yourself and will have the authority to consent, refuse to consent to medical treatment including decisions about withdrawing or withholding life-sustaining treatment. It is, therefore, important that you know and trust your agent and that your agent is aware of your preferences for health care treatment.

 

Even after you sign this document, you will still be able to make your health care decisions assuming you are still considered mentally competent. Your agent cannot act on your behalf until your physician has determined that you are no longer physically or mentally able to make medical decisions.

 

The person you choose as your agent must be at least eighteen years old and someone that you trust with your health care. Your agent is not liable for any decisions they make on your behalf, as long as those decisions were made in good faith. You should make sure that you have chosen agent wants to take on the role as agent. Discuss your medical preferences with your agent so they are aware of your wishes. Review this document with your agent so they are aware of their role. You also may choose a back-up agent in case your other agent is unavailable to act. Your back-up agent should also be over 18 and aware of your preferences.

 

You may revoke this document at any time while you are still competent to do so. You may revoke it by telling your medical provider and your agent that you are revoking the document or you may provide them a written revocation. If you execute another power of attorney later, that will have the effect of revoking this one.

 

In order for this document to be valid, it must be signed in the presence of a notary or two witnesses. If you choose to have two witnesses sign, they must be at least 18, competent and independent and not your agent or related to your agent.

MEDICAL POWER OF ATTORNEY

 

  1. APPOINTMENT OF HEALTH CARE AGENT

 

I, _______________________________ (Principal’s Full Name) of _____________________________ (Principal’s Street Address), City of _____________________________, State of _________________ (HEREINAFTER known as the “Principal”) hereby appoint, _______________________________ (Agent’s Full Name) of _____________________________ (Agent’s Street Address), City of _____________________________, State of _________________ (HEREINAFTER known as the “Agent”)as my Agent to make any and all medical decisions on my behalf, except to the extent I limit those decisions in this document. This power of attorney takes effect if my doctor certifies in writing that I can no longer make my own health care decisions. My agent can be reached at the following contact information:
 

Home Phone :____________________ Work Phone : ____________________
 

Cell Phone: ____________________ E-Mail: ____________________________

 

  1. LIMITATIONS ON MY AGENT

 

My agent is authorized to make all medical decisions on my behalf EXCEPT for the following:

_______________________________________________________________

 

_______________________________________________________________

 

_______________________________________________________________

 

  1. APPOINTMENT OF ALTERNATE AGENT

 

If my agent appointed above is unable or unwilling to serve as my agent, I appoint the following person(s) to serve as agents in the order set forth below with the authority to make health care decisions on my behalf as provided herein:

 

  1. First Alternate Agent

 

Name: _____________________________________________________

 

Address: ___________________________________________________

 

Phone: _____________________________________________________

 

  1. Second Alternate Agent

 

Name: _____________________________________________________

 

Address: ___________________________________________________

 

Phone: _____________________________________________________

 

  1. ORIGINAL AND COPIES OF THIS DOCUMENT

 

The original document is/will be filed in the following place:

 

________________________________________________________________

 

________________________________________________________________

 

________________________________________________________________

 

I have/will provided copies of my medical power of attorney to the following:

 

 ________________________________________________________________
 

________________________________________________________________

 

 ________________________________________________________________

 

  1. DURATION

 

Unless stated otherwise herein, this document shall remain in effect until I revoke it. I understand that I cannot revoke this document during the time I am considered incompetent to make my own decisions.

 

(If applicable Initial and Check)

 

___________ ☐  (OPTIONAL) This power of attorney shall expire on ____ day

 

of _________________________, 20____.

 

  1. PRIOR MEDICAL POWER OF ATTORNEY

 

By signing this document, I hereby revoke any and all prior medical powers of attorney that I may have executed.

  1. EXECUTION

 

(YOU MUST DATE AND SIGN THIS POWER OF ATTORNEY. YOU MAY SIGN IT AND HAVE YOUR SIGNATURE ACKNOWLEDGED BEFORE A NOTARY PUBLIC

OR

 

YOU MAY SIGN IT IN THE PRESENCE OF TWO COMPETENT ADULT WITNESSES NOT RELATED BY BLOOD OR MARRIAGE.)

 

SIGNATURES

 

I /We hereby execute this document on ____ day of _____________________, 20____

 

in the City of ________________________, State of _______________.

 

 

Principal’s Signature _____________________ Print Name ______________________

 

Agent’s Signature _____________________ Print Name ______________________

 

1st Alt. Agent’s Signature ____________________ Print Name ___________________

 

2nd Alt. Agent’s Signature ____________________ Print Name ___________________

 

 

NOTARY ACKNOWLEDGMENT

STATE OF __________________

 

__________________ County, ss.

 

On this ____ day of __________________, 20____, before me appeared

 

____________________, as Maker of this Medical Power of Attorney who proved to me through government issued photo identification to be the above-named person, in my presence executed foregoing instrument and acknowledged that (s)he executed the same as his/her free act and deed.

     

_________________________________________

Notary Public 

 

Print Name: _____________________     

 

My commission expires: _____________________

 

 

 

WITNESS STATEMENT AND ACKNOWLEDGMENT:

 

I am not the person appointed as agent or successor agent in this medical power of attorney. I am not related to the maker of this document by blood or marriage. I am not entitled to any portion of the maker's estate, nor do I have any claim against the maker’s estate. I am not the attending physician of the maker or an employee of the attending physician. I am not involved in providing direct patient care to the maker and am not an officer, director, partner, or business office employee of the health care facility or of any parent organization of the health care facility.

 

SIGNATURE OF FIRST WITNESS

 

Signature: ________________________________________________

         

Print Name: ___________________________________ Date: __________

         

Address: __________________________________________________

 

 

SIGNATURE OF SECOND WITNESS

 

Signature: ________________________________________________

         

Print Name: ___________________________________ Date: __________

         

Address: __________________________________________________

Disclaimer

CocoSign represents a wide collection of legal templates covering all types of leases, contracts and agreements for personal and commercial use. All legal templates available on CocoSign shall not be considered as attorney-client advice. Meanwhile, CocoSign shall not be responsible for the examination or evaluation of reviews, recommendations, services, etc. posted by parties other than CocoSign itself on its platform.

Easier, Quicker, Safer eSignature Solution for SMBs and Professionals

  • No credit card required
  • 14 days free