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Advance Directives

 Title Description English Version Spanish Version
I. Pertaining to Medical Matters:





1) Directive to Physicians and



Family or Surrogates Form

Advance Directives Act (see Health and Safety Code, Chapter 166, Sec. 166.033). This form is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury.   
2) Medical Power of Attorney Form



Advance Directives Act Form (see Health and Safety Code, Chapter 166, Sec. 166.164). Unless you state otherwise, this document gives the person you name as your agent the authority to make any and all health care decisions for you in accordance with your wishes, including your religious and moral beliefs, when you are no longer capable of making them yourself.







   
3) Out-of-Hospital Do-Not-Resuscitate Order Form



Texas Department of State Health Services. This form instructs emergency medical personnel and other health care professionals to forgo resuscitation attempts and to permit the patient to have a natural death with peace and dignity. This order does not affect the provision of other emergency care including comfort care.
   
       
II. Pertaining to Financial Matters:





4) Texas Statutory Durable Power of Attorney (POA)

This allows you to name another person, usually your spouse or children, as your agent to manage your assets on your behalf should you become incapacitated. This form must be notarized.    
For more information, visit TX Department of Aging and Disability Services (DADS) Advance Directives.







As of January 1, 2014 a NEW TEXAS STATUTORY DURABLE POWER OF ATTORNEY is available. The new form will be available shortly on our website.

Appointment            of Agent



to  Control



Disposition of



Remains




Important:
Per Texas law the person designated in the document Appointment of Agent to Control Disposition of Remains is authorized to make the final arrangements. However, it is recommended that the next-of-kin agrees in writing to the disposition wishes, particularly in case of a cremation and if the partners are not married. Reason: We have heard from funeral homes that they require such a written agreement in order to avoid any legal problems later on. For additional information and the Appointment of Agent to Control Disposition of Remains form click on this link: https://www.funerals.org/forconsumersmenu/your-legal-rights/funeral-decision-rights











Forms

Title Description
FCAH Membership Form Membership form for Funeral Consumers Alliance of Houston  
Certificate of Death Form

Texas Certificate of Death form.
Instructions for completion of death certificate:
http://www.dshs.state.tx.us/vs/handbooks/death/chapter-4(2).pdf

Contribution Form Thank you for your tax-deductible contribution
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