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Texas Health And Safety Code
166.164 Form Of Medical Power Of
Attorney
Sec. 166.164. FORM OF MEDICAL POWER OF ATTORNEY. The medical power of attorney must
be in substantially the following form:
MEDICAL
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How to fill out medical-power-of-attorney

How to fill out medical-power-of-attorney
01
Obtain the necessary form for a medical power of attorney, which is also known as a healthcare proxy or healthcare power of attorney.
02
Choose a trusted individual to act as your medical power of attorney. This should be someone who knows your wishes regarding medical treatment and is willing and able to make decisions on your behalf.
03
Fill out the form with your personal information, including your name, address, and contact information.
04
Specify the powers you are granting to your medical power of attorney, such as the ability to make medical decisions on your behalf in the event of your incapacity.
05
Sign and date the form in the presence of witnesses or a notary, as required by state law.
06
Make copies of the completed form and provide them to your healthcare providers, as well as to your designated medical power of attorney.
Who needs medical-power-of-attorney?
01
Anyone who wants to ensure that their medical treatment preferences are followed in the event that they are unable to communicate or make decisions for themselves.
02
Individuals with chronic health conditions or terminal illnesses may benefit from having a medical power of attorney in place.
03
Adults who want to designate a trusted person to make medical decisions on their behalf should they become incapacitated.
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What is medical-power-of-attorney?
A medical power of attorney is a legal document that allows an individual to designate another person to make healthcare decisions on their behalf in case they become incapacitated.
Who is required to file medical-power-of-attorney?
Any individual who wishes to appoint someone to make medical decisions for them in case of incapacity may file a medical power of attorney.
How to fill out medical-power-of-attorney?
To fill out a medical power of attorney, a person must complete the required form, specify the person they are appointing as their agent, outline the scope of their authority, and sign the document before witnesses or a notary, as per local regulations.
What is the purpose of medical-power-of-attorney?
The purpose of a medical power of attorney is to ensure that an individual's healthcare preferences are honored and to provide guidance on medical decisions when they are unable to communicate their wishes.
What information must be reported on medical-power-of-attorney?
The information typically reported on a medical power of attorney includes the principal's details, agent's details, specific powers granted, any limitations on the agent's authority, and signatures of the principal and witnesses or notary.
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