How to Fill Out Texas Medical Power of Attorney (w/Examples) + FAQs

A Texas Medical Power of Attorney (MPOA) is the statutory document that lets you name an adult agent to make health care decisions for you when a doctor certifies you cannot make them yourself. Every competent adult in Texas can sign one under Texas Health and Safety Code Chapter 166, Subchapter D, and the form takes effect only when your attending physician documents your incapacity in your medical record.

Roughly two-thirds of Texans die without ever signing an advance directive, according to data tracked by the Texas Hospital Association and national surveys cited by the American Bar Association Commission on Law and Aging. That gap forces families into court guardianships that average 6 to 18 months and cost thousands. This guide walks you through the official Texas Health and Human Services form, line by line, with named examples.

• 📝 How to fill out every field on the official Texas MPOA form, including the disclosure statement and agent acceptance.
• 👥 Who can serve as your agent, who is disqualified, and how to name a strong alternate.
• ✍️ How to satisfy the two-witness or notary signing rule, and which witnesses Texas law disqualifies.
• 🏥 How to deliver copies to your doctor, hospital, family, and patient portals like MyChart so the document actually works.
• ❌ The 10 most common mistakes that void a Texas MPOA, plus how to revoke or replace one cleanly.

What the Texas Medical Power of Attorney Is and Who Must File It

The Texas Medical Power of Attorney is a statutory advance directive authorized by Texas Health and Safety Code §166.152 that designates an “agent” to make health care decisions on your behalf. The form’s exact disclosure language is set by §166.164, which is why the Texas HHS form and the Texas Medical Association version read almost identically. The current HHS revision is dated September 1, 2018, and that date should appear on the bottom of the PDF you sign.

Anyone 18 or older, or a minor who is or has been married or has had the disability of minority removed, may sign one. You do not “file” the MPOA with a court or state agency. Instead, you sign it, deliver copies to your treating providers, and let it sit dormant until a physician documents incapacity in writing in your chart.

The MPOA is different from a Directive to Physicians (living will), an Out-of-Hospital DNR, and a financial Statutory Durable Power of Attorney under Estates Code Chapter 752. The MPOA covers medical decisions only. It does not authorize your agent to access your bank accounts, file taxes, or sign mental health treatment consents (those go in a Declaration for Mental Health Treatment).

Federal law sits behind the form too. HIPAA (45 C.F.R. §164.502(g)) recognizes a properly appointed health care agent as the patient’s “personal representative,” giving them full access to medical records once the MPOA is in effect.

Before You Start: Documents and Information You Need

Walking up to the form cold is the fastest way to make a mistake. Gather everything below first, then sit down for one focused session.

• Your full legal name as it appears on your driver license or Social Security card, because hospitals match the MPOA against your medical record on intake.
• Your agent’s full legal name, home address, daytime phone, and a backup mobile number, since hospitals need to reach the agent within minutes of an incapacity finding.
• A first alternate agent’s full contact info and a second alternate’s, because Texas law in §166.152(e) lets the alternate act only if the primary is unavailable, unwilling, or disqualified.
• A list of any specific limitations you want to impose, such as “no experimental treatment without family meeting,” because vague limits create bedside disputes.
• The names of two qualified witnesses or a Texas notary, because the form must be executed with two witnesses or acknowledged before a notary under §166.154.
• A separate HIPAA authorization, because while the MPOA grants access once it is in effect, a stand-alone HIPAA release lets your agent gather records before incapacity to prepare.
• Your primary care physician’s name, fax, and patient-portal address, since most Texas health systems (Baylor, Methodist, HCA, Memorial Hermann) accept uploads through MyChart.
• Photo ID for you and each witness, because notaries must verify identity under Texas Government Code §406.013.
• Your existing advance directives, because signing a new MPOA revokes prior ones to the extent of any conflict under §166.155.
• A scanner or phone-camera app to make PDF copies, because paper-only delivery routinely fails when the patient is admitted to a hospital across town.

Where to Get the Form and How to Access It

The official statutory form lives on the Texas Health and Human Services advance directives page. Download the bilingual English/Spanish PDF directly so you have the legally required disclosure statement word-for-word. Avoid third-party “free template” sites that strip or paraphrase the disclosure, because §166.163 makes the disclosure mandatory.

You can also pull the form from the Texas Medical Association MPOA page, which mirrors the statute and adds a plain-English cover sheet. Texas hospitals usually keep stacks at admissions desks, and the State Bar of Texas Senior Texans handbook prints the form as an appendix.

If you want a typeable version, open the HHS PDF in Adobe Acrobat Reader or Preview on macOS, fill the fields on screen, then print for signing. Texas does not currently accept e-signatures on the MPOA in most clinical settings, even though Texas Business and Commerce Code §322.003(b)(3) excludes most family and health care directives from the Uniform Electronic Transactions Act. Print, sign with a wet-ink pen, and scan after.

The form is free. There is no filing fee because there is no filing. Notarization typically costs $6 per signature under Government Code §406.024, and many banks, UPS Stores, and H-E-B locations notarize for customers.

Step-by-Step: How to Fill Out the Texas Medical Power of Attorney Line by Line

Work top to bottom. Do not skip the disclosure pages, even though they look like boilerplate, because a missing or altered disclosure can void the document under §166.163.

Disclosure Statement (Pages 1–2)

The disclosure is a two-page plain-language warning that explains what the MPOA does and what powers your agent will hold. You do not write anything on these pages. You read them. Texas law requires the disclosure to be presented exactly as printed in §166.164.

How to “answer” it: read every paragraph. If a sentence is unclear, stop and call your physician or an attorney before going further. The most consequential line is the one stating that your agent can consent to withholding or withdrawing life-sustaining treatment.

Example: Maria Lopez, age 72, reads the disclosure on her kitchen table with her daughter present, then dates her reading at the top margin “05/12/2026” so she remembers when she reviewed it.

Nuance: if you cannot read English or Spanish well, Texas allows a translator to read the disclosure aloud, but the translator should not also serve as a witness because of bias risk.

Common mistake and consequence: filers tear off or skip the disclosure pages when they photocopy the form. Hospitals that receive an MPOA without the disclosure may treat it as defective and call ethics committee.

Misconception: people think the disclosure is “just legalese.” It is the legally required teaching document, and a physician can refuse to honor an MPOA where the disclosure was clearly never delivered.

Designation of Health Care Agent: “I, ___”

This is the principal’s full legal name line at the very top of the operative form. It identifies you as the person granting the power. Match what is on your government ID.

How to answer: print your first name, middle name, and last name in all caps. Do not use nicknames.

Example: Maria Elena Lopez writes “MARIA ELENA LOPEZ” in the blank.

Nuance: if you have legally changed your name (marriage, divorce, court order), use the current legal name and keep the name-change order with the MPOA so providers can match older records.

Common mistake and consequence: using a nickname like “Liz” instead of “Elizabeth” creates a mismatch with the medical record number, which can delay an agent’s access at admissions.

Misconception: people believe a nickname is fine because “the family knows who I am.” Hospital admitting staff do not know, and they go by ID.

Name and Address of Agent

This is the line that names the person you trust to make decisions. Texas calls this the “agent.” §166.152(b) requires that the agent be a competent adult.

How to answer: print the agent’s full legal name, then their street address, city, state, ZIP, home phone, and cell. Add an email if your hospital portal uses one.

Example: Maria writes “CARLOS RAMON LOPEZ, 4412 Oak Bend Dr., Houston, TX 77057, (713) 555-0142” because her son Carlos has agreed in advance to serve.

Nuance: agents who live out of state are legal but practically slow. If your agent lives in California, name a Texas-based alternate first and the out-of-state child as backup.

Common mistake and consequence: naming your treating physician, an employee of your health facility, or your residential care provider (unless they are a relative). §166.153 disqualifies these people, and naming them voids the appointment.

Misconception: filers think “my doctor knows me best, so I’ll name him.” Texas bars that arrangement to avoid conflicts of interest.

First Alternate Agent

Use this line for a backup who steps in if your primary cannot serve. The alternate has every power the primary had, but only when the primary is unavailable, refuses, or is disqualified.

How to answer: print full legal name, address, and two phone numbers, just like the primary agent block.

Example: Maria names her daughter “ANA LOPEZ MARTINEZ, 8901 Memorial Dr., Houston, TX 77024, (281) 555-0199” as first alternate.

Nuance: do not name two co-agents to “share” the role. Texas does not authorize joint agents on the statutory form, and hospitals will reject conflicting instructions.

Common mistake and consequence: leaving the alternate blank because “my husband will always be there.” If your husband is in the same car accident as you, no one has authority and your family ends up in a guardianship hearing under Estates Code Chapter 1101.

Misconception: people assume the alternate can override the primary. The alternate has zero authority while the primary is willing and able.

Second Alternate Agent

The second alternate is your last line of defense. The form provides a third name slot for a reason.

How to answer: print full legal name, address, and contact info, identical format to the prior two blocks.

Example: Maria names her brother “JORGE ESPINOZA, 2200 Westheimer Rd., Houston, TX 77098, (832) 555-0166” as second alternate.

Nuance: pick a second alternate who is a generation younger than you if possible, because longevity matters with directives signed decades before they are needed.

Common mistake and consequence: naming a same-age sibling whose own health may decline alongside yours. The result is a “stale” MPOA where every named person is incapacitated.

Misconception: filers think second alternates “almost never matter.” During the COVID-19 surge, Texas hospitals reported moving to second and even third alternates because primary agents were themselves admitted.

Limitations on Agent’s Authority

This is an optional fill-in line for restrictions you want to place on the agent. Leave it blank to grant the broadest authority Texas law allows.

How to answer: write specific, medically meaningful limits in plain English. Avoid vague language like “use your best judgment.”

Example: Maria writes “My agent shall not consent to electroconvulsive therapy or to any psychosurgery.” because she has a personal objection.

Nuance: limits cannot expand the agent’s powers beyond what Chapter 166 grants. They can only narrow them.

Common mistake and consequence: writing religious or philosophical statements (“Do everything possible”) that do not translate into clinical orders. Hospitals cannot follow non-clinical language and may disregard it entirely.

Misconception: people think this is the place to refuse a feeding tube or ventilator. That belongs in your Directive to Physicians, not the MPOA.

Duration of the Power

The form lets you set an end date or leave it open-ended. The default under §166.152(e) is that the MPOA never expires unless you say so or revoke it.

How to answer: leave the field blank for a permanent MPOA, or write a specific end date in MM/DD/YYYY format.

Example: Maria leaves the duration blank, because she wants the document to last for the rest of her life.

Nuance: if you are a college student going abroad for one semester and naming a parent for that period only, write “This power expires on 12/31/2026.”

Common mistake and consequence: writing “until I am better” or “for one year.” Vague terms force hospitals to call legal counsel and can effectively pause your agent’s authority during a crisis.

Misconception: filers believe the MPOA expires when they recover capacity. It does not. It simply goes dormant until incapacity is documented again.

Principal’s Signature and Date

This is the operative line. Without your signature, none of the above matters.

How to answer: sign in wet ink, and print the date as MM/DD/YYYY.

Example: Maria signs “Maria Elena Lopez” in cursive on the signature line and dates it “05/12/2026.”

Nuance: if you cannot physically sign because of injury, §166.154(a) lets another adult sign for you in your presence and at your express direction. That adult cannot be a witness or your agent.

Common mistake and consequence: dating the form a different date than the witnesses. Mismatched dates suggest the witnesses were not present, which can void the form.

Misconception: people think initials are enough. The statute requires a signature.

Statement of First Witness

Texas requires two witnesses or a notary. The first witness can be almost anyone, but with restrictions.

How to answer: the witness signs, prints their name, and writes their address.

Example: Maria’s neighbor “Patricia Nguyen, 4416 Oak Bend Dr., Houston, TX 77057” signs as first witness because she is unrelated, not in the will, and not on the medical staff.

Nuance: the first witness is the “general” witness and has the fewest restrictions, but in practice everyone uses the §166.003 safer-witness criteria for both witnesses.

Common mistake and consequence: using your agent as the first witness. The agent is expressly disqualified as a witness under §166.003(2)(A), and using them voids the witnessing.

Misconception: filers think notaries can stand in for both witnesses. A notary substitutes for the witnesses entirely; you do not also need two witnesses if you notarize.

Statement of Second Witness (Qualified Witness)

The second witness must meet stricter criteria laid out in §166.003 and §166.154. This is the most error-prone block on the entire form.

How to answer: the second witness signs, prints their name, and writes their address. They must not be: the named agent, related to you by blood or marriage, entitled to any part of your estate, your attending physician or the physician’s employee, an employee of a health care facility where you are a patient (unless not directly involved in your care), or a creditor.

Example: Maria’s pastor “Reverend Daniel Cho, 1500 Bering Dr., Houston, TX 77057” signs as second witness because he meets every disqualification rule.

Nuance: a coworker who is not in your will and not a creditor is usually a safe second witness. So is a notary’s office staff member at a UPS Store, as long as they are not the notary handling the document.

Common mistake and consequence: asking your sister, your child, or anyone in your will to sign as the second witness. That single error makes the form unenforceable in Texas.

Misconception: people think “I trust my sister, so she should witness.” Trust is not the standard. Statutory disqualification is.

Notary Acknowledgment (Alternative to Witnesses)

Instead of two witnesses, you can have your signature acknowledged by a Texas notary public.

How to answer: sign in front of the notary, present photo ID, and let the notary complete the certificate, seal, and journal entry.

Example: Maria signs at her local Chase branch and notary “Linda Tran, Commission #133456789, expires 09/14/2028” stamps the acknowledgment.

Nuance: an online notary in Texas (RON) under Government Code §406.101 is permitted, although some hospitals still question RON-notarized advance directives, so wet-ink notarization is safer.

Common mistake and consequence: signing the form before meeting the notary. A notary cannot acknowledge a signature they did not see, and re-signing on top of the original ink is not a fix.

Misconception: filers assume notarization is “stronger” than two witnesses. Both are equally valid under Texas law.

Statement of Agent (Acceptance)

The bottom of the form contains a separate signature block where the agent acknowledges the duties of the role. Texas does not require this for validity, but completing it dramatically reduces hospital pushback.

How to answer: the agent signs, prints their name, and dates the line. Each alternate should also sign their own acceptance line if the form has them.

Example: Carlos Lopez signs “Carlos R. Lopez” and dates “05/12/2026.”

Nuance: an agent can accept later, even years after the principal signs. But getting acceptance up front avoids the awkward bedside scene where a hospital asks “are you actually willing to serve?”

Common mistake and consequence: skipping the acceptance because “it’s not required.” Many Houston and Dallas hospital systems policy-require acceptance and will pause until they can reach the agent.

Misconception: people think the agent acceptance binds the agent permanently. The agent can resign at any time by giving written notice to the principal or the treating physician.

Three Filled-Out Examples Using Real Scenarios

The three scenarios below show how very different Texans complete the same form. Each table tracks one person through the key sections.

Scenario 1: Maria, 68-year-old Widow Preparing for Knee Surgery

Form Section	What Maria Enters
Principal’s name	MARIA ELENA LOPEZ
Agent	CARLOS RAMON LOPEZ, 4412 Oak Bend Dr., Houston, TX 77057, (713) 555-0142
First alternate	ANA LOPEZ MARTINEZ, 8901 Memorial Dr., Houston, TX 77024, (281) 555-0199
Second alternate	JORGE ESPINOZA, 2200 Westheimer Rd., Houston, TX 77098, (832) 555-0166
Limitations	No electroconvulsive therapy. No psychosurgery.
Duration	Blank — permanent until revoked.
Principal’s signature/date	Maria Elena Lopez — 05/12/2026
Witness 1 / Witness 2	Patricia Nguyen (neighbor) / Reverend Daniel Cho (pastor)
Agent acceptance	Carlos R. Lopez — 05/12/2026

Scenario 2: Janelle, 35-Year-Old with a New MS Diagnosis

Form Section	What Janelle Enters
Principal’s name	JANELLE RENEE WALKER
Agent	DARIUS T. WALKER (spouse), 612 Cedar Park Ln., Austin, TX 78745, (512) 555-0181
First alternate	KIMBERLY WALKER-OYELOWO (sister), 3300 Slaughter Ln., Austin, TX 78748, (512) 555-0144
Second alternate	Blank — declined to name a third
Limitations	Agent shall consult my treating neurologist before consenting to any clinical trial.
Duration	Blank — permanent
Principal’s signature/date	Janelle R. Walker — 04/30/2026
Notary block	Acknowledged by Notary Linda Tran, Comm. #133456789
Agent acceptance	Darius T. Walker — 04/30/2026

Scenario 3: Sam, 50-Year-Old Single Man Naming a Close Friend

Form Section	What Sam Enters
Principal’s name	SAMUEL ANDREW BRENNAN
Agent	ROBERT “BOBBY” KIM (friend, 22 years), 1800 N. Buckner Blvd., Dallas, TX 75228, (214) 555-0107
First alternate	EILEEN BRENNAN (mother), 909 Live Oak St., Plano, TX 75074, (972) 555-0125
Second alternate	FATHER MICHAEL OYEDEPO (priest), 700 Ross Ave., Dallas, TX 75201, (214) 555-0188
Limitations	No long-term tube feeding if I am in a permanently unconscious state.
Duration	Blank — permanent
Principal’s signature/date	Samuel A. Brennan — 06/02/2026
Witness 1 / Witness 2	Co-worker Gloria Tan / UPS Store clerk Marcus Levy (not the notary)
Agent acceptance	Robert Kim — 06/02/2026

You will see five named filers across this article: Maria Lopez, Janelle Walker, Sam Brennan, plus two more we mention below — Aisha Bello, a 28-year-old Houston graduate student naming her father, and Walter Henderson, a 78-year-old El Paso widower replacing an outdated 1998 directive.

How to File the Completed Form

The Texas MPOA is not “filed” with a court. Distribution is the closest equivalent, and the Texas Medical Association distribution checklist lists the standard recipients.

• In person to your primary care physician’s office: bring two original copies, ask the front desk to scan one into the chart, keep one. There is no fee. Processing time is typically same-day, and the proof of filing is a stamped copy from the receptionist.
• In person to your preferred hospital’s medical records department: examples include Houston Methodist Health Information Management and UT Southwestern Medical Records. No fee. Same-day scan. Proof is the records department’s date-stamped receipt.
• Patient portal upload to MyChart or FollowMyHealth: scan the signed PDF and upload through the “Documents” or “Advance Directives” tab. Free. Processing usually completes within 24 hours, and proof is the portal’s upload confirmation email.
• By mail to your hospital system: send via USPS Certified Mail with Return Receipt under USPS Form 3811. Postage runs about $5.65 in 2026. Processing takes 7–10 business days, and the green return-receipt card is your proof.
• By fax to your physician’s office: confirm the fax number first, then keep the transmission report. Free if you have a fax line, or about $2/page at a UPS Store. Same-day processing once received.
• To your agent and alternates personally: hand-deliver an original or a clear photocopy. Ask them to store it where they can find it under stress.
• Optionally with the U.S. Living Will Registry or a similar service, which charges a one-time fee around $45 and provides a 24/7 retrieval line for hospitals.

Texas does not run a state advance directive registry, despite a long-standing proposal. The Texas Secretary of State does not accept MPOAs. Storing the document only in a safety deposit box is risky because banks may not be open during a medical emergency.

What Happens After You File

Once distributed, the MPOA sits dormant in your medical record. It activates only when your attending physician certifies in writing in the chart that you lack capacity to make a particular health care decision, per §166.152(c).

When activated, your agent steps into your shoes for that decision. They can consent to or refuse treatment, hire and fire providers, request transfer between facilities, and access records under HIPAA. They cannot consent to voluntary inpatient psychiatric admission, abortion, or neglect of comfort care, all of which are carved out by §166.152(f).

If you regain capacity — say after surgery anesthesia wears off — the MPOA goes dormant again automatically. You do not need to “reclaim” your authority, and your physician documents your renewed capacity in the chart.

If a family member disputes the agent’s decisions, Texas allows them to seek a temporary restraining order or guardianship under Estates Code Chapter 1251. Disputes are rare when the MPOA is well-drafted and family was informed in advance.

Mistakes to Avoid When Filling Out the Form

• Naming your treating physician as agent. The form is void as to that designation under §166.153.
• Using your spouse as second witness. Spouses are disqualified under §166.003, and the form fails witnessing.
• Skipping or photocopying without the disclosure pages. Hospitals may treat the document as defective and call risk management.
• Leaving the agent’s address and phone blank. Hospitals cannot reach the agent, and your alternate may take over by default.
• Naming co-agents or “joint” agents. Texas does not authorize joint agents on the statutory form, and conflicts paralyze decisions.
• Writing emotional language in the limitations line. Vague language (“don’t let me suffer”) is unenforceable and can be ignored.
• Signing without dating. Undated signatures invite challenges to the order of signing, and witness statements anchor to the principal’s date.
• Notarizing online when your hospital rejects RON. The MPOA may be technically valid but practically delayed.
• Forgetting to update after a divorce. An ex-spouse remains your agent unless you sign a revocation or a new MPOA.
• Storing the only original in a safe deposit box. Banks are closed nights, weekends, and holidays — exactly when emergencies happen.
• Naming an agent who lives abroad without a Texas alternate. Time zones and travel delays can cost critical decision hours.
• Failing to give the form to your agent. An agent who does not know they were named cannot present the form at admissions.

Do’s and Don’ts

• Do read the disclosure pages slowly and ask your doctor about anything unclear, because the disclosure controls how hospitals interpret your authority grant.
• Do match your principal name to your driver license exactly, because hospitals cross-check by ID.
• Do name a first and second alternate, because mass-casualty events in Texas (Hurricane Harvey, the 2021 freeze) have shown that primaries are sometimes incapacitated alongside the principal.
• Do sign in wet ink, because most Texas hospitals still prefer wet ink even where digital is technically valid.
• Do upload to your patient portal, because that is the fastest channel for ER admissions to find the form.
• Do tell your agent in detail what you would and would not want, because the form grants authority but does not script values.
• Don’t use a friend who works at your hospital as a witness unless they are uninvolved in your care, because the disqualification rule in §166.003 is strict.
• Don’t combine the MPOA with a financial power of attorney on one document, because they are governed by different statutes and hospitals will reject mixed forms.
• Don’t try to handwrite a custom MPOA from scratch, because deviating from §166.164 language risks invalidation.
• Don’t let the form sit unsigned for months “until everyone is together,” because intervening incapacity makes signing impossible.
• Don’t forget to revoke prior MPOAs in writing, because conflicting documents create bedside chaos.
• Don’t store the only original at home in a fireproof safe your agent cannot open, because emergencies do not wait for locksmiths.

Pros and Cons of Filing on Your Own vs. With Help

Most Texans complete the MPOA without an attorney. Some situations call for help.

• Pro of pro se filing: zero cost beyond a $6 notary fee, because the form itself is free at HHS.
• Pro of pro se filing: speed, because you can sign in one afternoon.
• Pro of pro se filing: privacy, because you do not share family details with a third party.
• Pro of pro se filing: control, because you write your own limitations.
• Pro of pro se filing: simplicity, because the statutory form is intentionally plain English.
• Con of pro se filing: easy to miss disqualified witnesses, because the disqualification list in §166.003 is long.
• Con of pro se filing: risk of conflicting prior directives, because lay filers rarely revoke older forms.
• Con of pro se filing: weak limitations language, because plain-English wishes don’t always map to clinical orders.
• Con of pro se filing: family conflict if the agent choice surprises others, because no neutral counselor framed the conversation.
• Con of pro se filing: no integration with estate plan, because the MPOA may not align with your will or trust.
• Pro of attorney help: bundled package with a Directive to Physicians, HIPAA release, Statutory Durable POA, and will, often for $300–$800 in Texas markets.
• Con of attorney help: cost and time, especially when the statutory form would have worked unaided.

Pro Se vs. Attorney-Drafted MPOA at a Glance

Factor	Texas Filer’s Choice
Cost	Pro se: ~$6 notary. Attorney: $300–$800 bundled.
Time to sign	Pro se: 1 day. Attorney: 1–2 weeks.
Risk of disqualified witness	Pro se: higher. Attorney: low.
Coordination with will/trust	Pro se: none. Attorney: built-in.
Plain-language disclosure	Both use the §166.164 text.
Revocation of prior MPOA	Pro se: filer must remember. Attorney: handled in engagement.
Hospital acceptance rate	Equal when both forms are properly executed.
Best for	Pro se: simple family situations. Attorney: blended families, business owners, special-needs heirs.

How to Revoke or Replace an MPOA

You can revoke a Texas MPOA at any time, in any way that communicates intent to revoke, under §166.155. The cleanest method is to sign a new MPOA naming a different agent, because the new form supersedes the old to the extent of conflict.

You can also revoke orally to your attending physician, who must record the revocation in your chart. A signed and dated written revocation, delivered to the agent and to every provider who has the old form, leaves the smallest paper-trail risk. Walter Henderson, our 78-year-old El Paso filer, replaced his 1998 MPOA naming his late wife by signing a 2026 MPOA naming his adult son and faxing revocation notices to his cardiologist, primary care physician, and the University Medical Center of El Paso records office.

FAQs

Does a Texas MPOA need to be notarized?

No. A Texas MPOA can be either notarized or signed in front of two qualified witnesses under §166.154. You only need one of the two methods.

Can my agent be a family member who is in my will?

Yes. Your agent can absolutely be in your will. The estate-beneficiary disqualification applies only to the second witness, not to the agent.

Can I name my doctor as my agent?

No. Your treating physician and most of their employees are disqualified from serving as agent under §166.153, unless the employee is a relative.

Do I write my maiden name or my married name in the principal block?

Yes — use the legal name on your current ID. If you go by a married name now, write that, and keep your name-change order with the form for older medical records.

Can my second witness be my sister?

No. A relative by blood or marriage is disqualified as the second witness under §166.003, so picking a sister voids the witnessing.

Can I leave the “limitations” line blank?

Yes. Leaving it blank grants the broadest authority Texas law allows, which is what most filers actually want.

Do I have to use the HHS form, or can I write my own?

Yes — you must use the statutory disclosure language from §166.164. The HHS form is the safest way to comply, and home-grown wording risks invalidation.

Does my Texas MPOA work if I am hospitalized in another state?

Yes, in most states. Many states honor out-of-state advance directives if validly executed where signed, but check the destination state’s law before you travel for surgery.

Can I name two agents to act jointly?

No. Texas’s statutory form contemplates one agent at a time, with alternates serving in succession.

Does the MPOA cover mental health treatment?

No. Inpatient psychiatric commitment and similar mental health decisions require a separate Declaration for Mental Health Treatment.

What if I sign and then change my mind?

Yes, you can revoke any time by oral notice to your physician, by signing a new MPOA, or by a written revocation under §166.155.

Do I need to date the form in MM/DD/YYYY format?

Yes. Use MM/DD/YYYY to match the witness statements and avoid date-mismatch challenges that hospital legal teams flag during admission.

Does divorce automatically revoke an ex-spouse as agent?

Yes. Under §166.155(b), a divorce or annulment after signing revokes the ex-spouse’s appointment as agent, but you should still sign a new MPOA to remove ambiguity.

Can my agent see my medical records before I lose capacity?

No, not through the MPOA alone, which activates only on incapacity. Sign a separate HIPAA authorization so your agent can prepare in advance.

How often should I update my Texas MPOA?

Yes — review it every 3–5 years or after any major life event (marriage, divorce, death of agent, move, new diagnosis), because outdated agent information is the most common reason Texas hospitals delay honoring an MPOA.