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Texas Living Will Form (Directive to Physicians and Family or Surrogates) |
The Texas living will, known by the State as the ‘Directive to Physicians and Family or Surrogates’, is to allow a person to legally choose their medical treatment should they become incapacitated to such a degree that they are no longer rational to make these choices. This can be in the event of a coma or a serious illness like brain damage. It also extends to any end of life decisions from the principal if they so wish. For it to be a legally binding agreement the Texas living will requires a notary or two witnesses. It is in accordance with the US statutes §§166.031 to 166.053 and is legally binding for any periods of time stipulated by the principal.
How to Write
Living Will
The principal must sign date and time the bottom of each page.
Directive
The principal must enter their name and initial the relevant statement regarding their health care treatment in the event that their life expectancy is less than six months.
- To receive treatment only to provide comfort from pain.
- To receive treatment to sustain life.
The principal must initial the relevant statement regarding their health care treatment in the event that they can not care for themselves or are unable to make decisions for themselves and are suffering a terminal condition.
- To receive treatment only to provide comfort from pain.
- To receive treatment to sustain life.
The principal may enter details of any other specific wishes they have regarding their medical health care treatment.
Alternatives
The names of any alternative agent`s must be entered.
Signatures
The details of the principal, witnesses and notary must be entered.
- Principal`s signature.
- Date.
- County.
- Witnesses signature.
- Witnesses name.
- Witnesses address.
- Date.
- Date.
- City.
- State.
- Principals signature.
- Principal`s name.
- County.
- Date.
- Notary`s name.
- Notary`s name.
- Date of expiration of commission.
