ocultar mi visita

Instructions and Forms to Complete a Medical Power of Attorney

×

Status message

Actualmente, este contenido solo está disponible en inglés. Estamos trabajando en traducirlo, así que vuelva pronto para ver si ya esté disponible en español. Si necesita ayuda antes de que se traduzca, consulte nuestra Buscador de Ayuda Legal para encontrar una organización que pueda ayudarle.

Follow these steps to complete a Medical Power of Attorney form.

Ocultar lista de verificación

Step 1: Read the Disclosure Statement.

Review the Disclosure Statement form here:

    

Step 2: Fill out the Medical Power of Attorney form.

Get the Medical Power of Attorney form here:

Remember to:

  • Complete the form in blue or black ink.
  • Name the person you would want to be your agent in the event of your incompetency.
  • Write any limitations on the decision-making authority of your agent that you want to include.
  • Name any alternate agents if your first choice cannot serve at the time of your incompetency.
  • Sign and date the form in front of a notary OR in front of two witnesses. Also have the notary or witnesses sign and date the form.

 

Or use the following guided form:

Step 3: Make copies for your agents and health care providers.

Keep the original and give a copy of the Medical Power of Attorney to your:

  • Agent,
  • Any alternate agents, and your
  • Health care and residential health care provider(s).

Providing these copies helps secure a smooth transition in the event you become incompetent.

 

Where can I get help filling out the form?

Get help filling out the form by talking with your:

  • Physician,
  • Health care provider,
  • Residential health care provider, or
  • Lawyer. 

You can also use this guided form:

 

Do I need a lawyer to help me?

You do not have to have a lawyer, but naming an agent in a power of attorney is an important decision and having legal help can be a good idea. If you decide that you need legal help, there are options. 

You can:

  • Click here for information lawyer referral services in Texas
  • Check our Legal Clinic Calendar to learn if there is a free legal clinic in your area.
  • Use our directory to find free legal help to qualifying individuals.