A healthcare directive is read by hospital staff under time pressure, and the signature and witness block is the first thing they check. Here is exactly what Texas requires when you sign a healthcare directive, and how to run the signing so it holds up.
What Texas requires
Texas law accepts more than one route when a healthcare directive is signed: two witnesses, or acknowledgment before a notary public. The healthcare directive in your download is set up for two witnesses.
You complete one route, not both. Doing the other as well is harmless, but it is not what the statute asks of you.
Witnesses watch you sign (or hear you acknowledge the signature as yours) and then sign themselves, so everyone must be present at the same time.
Statutory detail: A Directive to Physicians and a Medical Power of Attorney may each be signed before two competent adult witnesses or acknowledged before a notary (Health and Safety Code §§ 166.032, 166.154). When witnesses are used, at least one witness must meet the disinterested-witness restrictions in § 166.003(2) — the statute names no witness position, and on this form that witness is Witness 1. The Medical Power of Attorney follows the § 166.164 statutory form, which embeds the required disclosure statement.
- Witnesses: 2
- Notary: not required
Step-by-step signing checklist
Follow the steps in order, and sign nothing until everyone who needs to be present is in the room.
- Print and review the final PDF: Print the final version single-sided and read every page. Confirm the names, dates, and the people you appointed before anyone signs — a correction after signing means re-signing.
- Arrange two witnesses: Ask two witnesses to be with you at the same time and place. Choose adults who receive nothing under the document, and ask each to bring photo ID.
- Sign in front of everyone: Sign and date where the healthcare directive indicates, with two witnesses watching. Do not sign ahead of time.
- Have the witnesses sign: Each witness signs the attestation section while you and the other witness watch, then prints their name and address by hand.
- Store the original and hand out copies: Keep the signed original somewhere safe and fireproof, tell the people you appointed where it is, and give them copies. Never write changes on the signed original — sign a corrected version instead.
Mistakes that undo a valid document
Most signing failures are procedural, not substantive — the document was fine and the ceremony was not.
- Signing before the witnesses or notary arrive, then asking them to sign later.
- Witnesses who sign at different times or out of each other's sight.
- Using someone who benefits under the document as a witness — it invites a challenge and, in some states, costs them their gift.
- Skipping a page, an initial line, or the date.
- Writing changes by hand on the signed original.
- Losing the original; a photocopy is often not enough.
After signing
The original is the document. Store it where it will survive a fire and a move, and make sure the people you appointed can find it without you.
Revisit the healthcare directive when your family, your finances, or the people you appointed change. A new version is signed the same way; the old one should be destroyed once the new one is complete.
Frequently Asked Questions
How many witnesses does a Texas healthcare directive need?
Two, on the route your document uses. They must be present at the same time, watching you sign or hearing you acknowledge the signature, before they sign themselves. Texas also accepts acknowledgment before a notary public instead of the witnesses.
Does a Texas healthcare directive have to be notarized?
Not on the route your document uses, which relies on the witnesses instead — but Texas accepts acknowledgment before a notary public as an alternative to them, and either satisfies the statute. A Directive to Physicians and a Medical Power of Attorney may each be signed before two competent adult witnesses or acknowledged before a notary (Health and Safety Code §§ 166.032, 166.154). When witnesses are used, at least one witness must meet the disinterested-witness restrictions in § 166.003(2) — the statute names no witness position, and on this form that witness is Witness 1. The Medical Power of Attorney follows the § 166.164 statutory form, which embeds the required disclosure statement.
Do the witnesses need to read the document?
Generally no. A witness attests that you signed willingly and appeared to know what you were doing — not to the contents. They need to see you sign, or hear you say the signature is yours.
What should I do with the signed original?
Keep it somewhere safe and fireproof, tell the people you appointed exactly where it is, and give them copies. If anything needs to change later, sign a corrected version rather than marking up the original.