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There are four types of advance directives. You can execute one, or several, depending on your needs and situation. Download and complete the Texas forms below in English or Spanish. Share copies with your doctor and your family, and take copies with you to the hospital.

Directive to Physicians and Family or Surrogates (English: PDF or MS Word)

  • This directive allows you to specify for the provision, withdrawal or withholding of medical care in the event of a terminal or irreversible condition.
  • Your condition must be certified by one physician.

Medical Power of Attorney (English: PDF or MS Word)

  • This directive allows you to designate another person as your agent for making health care decisions if you become incompetent.
  • You do not have to have a terminal or irreversible condition for a medical power of attorney to be used.

Out-of-Hospital Do-Not-Resuscitate Order (English: PDF)

  • This directive allows competent adults to refuse certain life-sustaining treatments in non-hospital settings where health care professionals are called to assist, including hospital ERs and outpatient settings.
  • You should carry a photocopy of your written form or wear a designated ID bracelet.
  • This directive cannot be executed for minors unless a physician states the minor has a terminal or irreversible condition.
  • Note: The PDF form in English must be properly executed in accordance with the instructions on the opposite side (download Spanish instructions separately) to be considered a valid form by emergency medical services personnel.

Declaration of Mental Health Treatment (PDF in English | PDF in Spanish)

  • This directive allows a court to determine when you become incapacitated, and when that declaration becomes effective.
  • You may opt not to consent to electro-convulsive therapy or to the use of psychoactive drugs.
  • The declaration expires in three years, unless you are incapacitated at that time.

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