Supported Decision-Making Agreement Tool

Use this tool to create your own Supported Decision-Making Agreement. To get an idea of what your agreement will look like, see our Sample Agreement. To learn more about this topic, see Making My Own Choices: An Easy-to-Follow Guide on Supported Decision-Making Agreements.

To create your Supported Decision-Making Agreement, follow these steps:

Complete the form below
Click the button at the bottom of this page
Download and print the PDF of your agreement
You and your supporter(s) sign the agreement in front of two witnesses or a notary public, who also sign the agreement
Keep your signed agreement in your files

If the options in this tool don't cover your specific situation, begin the intake process to apply for our services and get help creating your Supported Decision-Making Agreement.

Please note that a person can only enter into a Supported Decision-Making Agreement if they have the capacity to do so. This means that the person must be able to understand and explain the following:

What a Supported Decision-Making Agreement is
What types of decisions their supporter will assist them in making
That they will be the one making the decisions and not the supporter
That they can revoke the Supported Decision-Making Agreement at any time

Languages: this Supported Decision-Making Agreement generator is available in English and Spanish. Be aware that DRTx recommends that you provide the document in a language understandable to the party or entity receiving it, which in most circumstances will be English. This will better ensure the agreement is honored and followed as directed in the document.

Form

"*" indicates required fields

Your name * Required

Enter the first and last name of the adult with a disability.

Your email address

Enter the email address of the adult with a disability. If you enter your email address, a copy of your Supported Decision-Making Agreement will be emailed to you. If you don't have an email address, leave this field blank.

How many supporters will you have? * Required

You can have as many supporters as you want. This tool allows you to have up to two. If you want to include more than two supporters, begin the intake process to apply for our services and get help creating your agreement. Texas law requires all supporters to be 18 years of age or older.

1 supporter

2 supporters

Supporter's name * Required

Enter the first and last name of your supporter.

Supporter's address * Required

Enter your supporter's address, including the street address, city, state, and zip code.

Supporter's phone number * Required

If the supporter doesn't have a phone number, enter "n/a."

Supporter's email address

Enter your supporter's email address to be included in the Supported Decision-Making Agreement. Also, a copy of the agreement will be emailed to your supporter. If your supporter doesn't have an email address, leave this field blank.

Name of supporter #1 * Required

Enter the first and last name of your first supporter.

Address of supporter #1 * Required

Enter your first supporter's address, including the street address, city, state, and zip code.

Phone number of supporter #1 * Required

Enter your first supporter's phone number to be included in the Supported Decision-Making Agreement. If this supporter doesn't have a phone number, enter "n/a."

Email address of supporter #1

Enter your first supporter's email address to be included in the Supported Decision-Making Agreement. Also, a copy of the agreement will be emailed to this supporter. If your supporter doesn't have an email address, leave this field blank.

Name of supporter #2 * Required

Enter the first and last name of your second supporter.

Address of supporter #2 * Required

Enter your second supporter's address, including the street address, city, state, and zip code.

Phone number of supporter #2 * Required

Enter your second supporter's phone number to be included in the Supported Decision-Making Agreement. If this supporter doesn't have a phone number, enter "n/a."

Email address of supporter #2

Enter your second supporter's email address to be included in the Supported Decision-Making Agreement. Also, a copy of the agreement will be emailed to this supporter. If your supporter doesn't have an email address, leave this field blank.

What will your supporter(s) help with? * Required

Your supporter(s) can help you with life decisions. Check the life decisions below that your supporter(s) can help you with.

Obtaining food, clothing and a place to live

My physical health

My mental health

Managing my money or property

Getting an education or other training

Choosing and maintaining my services and supports

Finding a job

Other

Other help * Required

What life decisions not listed above will your supporter(s) help you with?

Health information * Required

Do you want your supporter(s) to see your private health information? If you select "Yes," you will need to complete a Supported Decision-Making Release of Confidential Information Form.

Yes

Education records * Required

Do you want your supporter(s) to see your educational records? If you select "Yes," you will need to complete a Supported Decision-Making Release of Confidential Information Form.

Yes

End date

When would you like your Supported Decision-Making Agreement to end? If you don't enter a specific date, your agreement will include an end date 10 years from now. Also, you and/or your supporter(s) can end the agreement at any time.

Month

Day

Year

You can share your agreement

Your Supported Decision-Making Agreement will automatically be emailed to the email addresses included above. If there is another person who should know about the agreement, enter their email address below and they will receive an unsigned copy of it. You can only enter one email address. You can also send the agreement you download and/or receive via email to others. If there isn't anyone else you want to share your agreement with, just leave this field blank.

Additional Information

The optional questions below are for the adult with a disability who is entering into a Supported Decision-Making Agreement. Thank you for answering these questions to help us ensure we reach a diverse group of Texans with disabilities.

What is your age?

What city do you live in?

What county do you live in?

Gender

Please select the gender you identify with.

Male

Female

Other

Please specify the gender you identify with.

Race

American Indian/Alaskan Native

Asian

Black/African American

Native Hawaiian/Other Pacific Islander

Race unknown

Two or more races

White

National origin/ethnicity

Hispanic/Latino

Not Hispanic/Latino

Are you a veteran?

Yes

Household income

What is the total income for your household in one year?

Household members

How many people are in your household?