Who fills out this form?

The parent completing the form and the voluntary adult caregiver fill out this agreement. It also requires information from the child's other parent.

Does this form give the caregiver all rights?

No, the form states that this agreement does not give the caregiver the rights of a legal guardian or managing conservator.

What happens if the parents don't sign it?

If both parents do not sign, a copy of the agreement must be mailed to the non-signing parent by certified mail and by first-class mail within ten days of signing.

FM-34-109-EN-ESLegal-aid form

Authorization Agreement for Voluntary Non-Parent Caregiver (Spanish Translation Attached)

Texas · TexasLawHelp.org

This form allows parents to give temporary legal rights to a non-parent caregiver to make certain decisions for a child. It lists the types of decisions the caregiver can make, such as medical care or school enrollment.

The court describes it as: With this form, parents can give nonparents temporary legal rights to care for children. State of Texas form with translation to Spanish attached. ...

Open the official PDFfrom TexasLawHelp.org

Where this fits in a case

Motions

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Respond
Motions
Discovery
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Judgment
After judgment
Appeal

Stage: Motions

This form is used when parents want to give temporary authority to an adult caregiver to make decisions for a child. The agreement details what the caregiver can do and includes rules about keeping each other updated on contact information.

Either party may file.

Common questions

Who fills out this form?: The parent completing the form and the voluntary adult caregiver fill out this agreement. It also requires information from the child's other parent.
Does this form give the caregiver all rights?: No, the form states that this agreement does not give the caregiver the rights of a legal guardian or managing conservator.
What happens if the parents don't sign it?: If both parents do not sign, a copy of the agreement must be mailed to the non-signing parent by certified mail and by first-class mail within ten days of signing.

Revision history

No changes recorded since we started tracking this form on October 9, 2026.

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