FamiliaLista › Guides › HIPAA release and out-of-hospital DNR in Texas: what each one does

By Frank Flores, founder of FamiliaLista · Updated November 3, 2026

HIPAA release and out-of-hospital DNR in Texas: what each one does

Three papers, three jobs. A HIPAA authorization lets your doctors share your health information with the people you name. A medical power of attorney lets someone decide for you when you can't. A Texas out-of-hospital DNR order tells EMS and other responders not to start CPR.

What does a HIPAA authorization do?

HIPAA already lets doctors share information with family or friends who are involved in your care, if you don't object. But they don't have to share it with anyone except your personal representative. A written authorization makes it clear: you name the people who can receive your health information. Source: HHS, HIPAA and family members and friends.

A valid authorization describes the information, names who may share it and who may receive it, gives the purpose, has an end date or event, and is signed and dated. You can revoke it in writing at any time; it stops once the provider gets your revocation. Sources: 45 CFR §164.508, authorizations, HHS, revoking an authorization.

How is it different from a medical power of attorney?

HHS treats someone with legal authority to make health care decisions for you, like a health care power of attorney, as your personal representative. In Texas, your agent's authority starts only after your doctor certifies in writing that you can't decide. A HIPAA authorization doesn't let anyone make decisions. It lets the people you name get information. See our Texas medical power of attorney guide. Sources: HHS, personal representatives under HIPAA, Tex. Health & Safety Code ch. 166.

After a death, HHS says the executor or administrator of the estate is the personal representative. The Texas standard form ends at the person's death. Sources: HHS, personal representatives under HIPAA, Texas Attorney General, standard authorization form.

Where do you get one?

Ask your doctor's office or hospital for theirs. The Texas Attorney General also adopted a standard form, "Authorization to Disclose Protected Health Information," with a section to list who can receive your information. You can withdraw it with written notice. Sources: Texas Attorney General, standard authorization form, Tex. Health & Safety Code ch. 181.

What is an out-of-hospital DNR order?

It's a legally binding order, signed by your attending physician, that tells health care professionals outside the hospital not to start or continue CPR, advanced airway management, artificial ventilation, defibrillation or cardiac pacing. It applies at home, in long-term care facilities and hospice, during transport, and in hospital outpatient and emergency departments. It doesn't stop comfort care, pain relief, water or nutrition. Sources: Tex. Health & Safety Code ch. 166, Texas DSHS, OOH-DNR questions and answers.

Who signs it?

You, if you're competent. If you can't, your guardian, medical power of attorney agent or proxy can sign, or a qualified relative such as your spouse, adult children or parents.
Your attending physician, with their license number. A physician assistant or nurse practitioner can't sign that part.
Two witnesses or a notary. At least one witness must meet the same rules as for a medical power of attorney.
Everyone signs again at the bottom of the page.

Sources: Texas DSHS, OOH-DNR questions and answers, Tex. Health & Safety Code ch. 166.

Where should you keep it?

Copies count like the original, but a photo on a phone doesn't. A DNR identification device, such as a bracelet or necklace, is honored in place of the form. When EMS takes you anywhere, a copy or the device must go with you. You can revoke it at any time by telling responders, destroying the form or removing the device. Source: Texas DSHS, OOH-DNR questions and answers.

Directive to physicians or out-of-hospital DNR?

The Directive to Physicians and Family or Surrogates (a living will) records your wishes about life-sustaining treatment if you have a terminal or irreversible condition. Any competent adult can sign it before two witnesses or a notary, then let their doctor know. The out-of-hospital DNR is a doctor's order for responders. Texas HHS posts both forms, plus the medical power of attorney, on one page. Sources: Tex. Health & Safety Code ch. 166, Texas HHS, advance directive forms.

Checklist

[ ] Sign a HIPAA authorization naming who can get your information.
[ ] Sign a medical power of attorney.
[ ] If you want one, talk with your doctor about an out-of-hospital DNR.
[ ] Get a DNR bracelet or necklace, if you have the order.
[ ] Tell your family where the originals are.

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Frequently asked questions

Does a HIPAA authorization let my daughter make decisions for me?

No. It lets the people you name get your health information. Decisions are what a medical power of attorney is for.

Who has to sign a Texas out-of-hospital DNR?

You or your legal representative, your attending physician, and two witnesses or a notary.

Does EMS accept a copy?

Yes, copies are honored like the original, but a phone photo is not. A DNR bracelet or necklace is also honored.

Is this legal advice?

No. It is general information from HHS and Texas law. Talk with your doctor and a Texas attorney about your situation.

Sources

General information, not legal or financial advice. Rules change; check the official sources above or talk to a licensed professional about your situation.