Laws
Statute – Advance Health Care Directive Act ( § 75-2A-101 – § 75-2A-1125)
Definitions – “Advance health care directive”: Includes: a designation of an agent to make health care decisions for an adult when the adult cannot make or communicate health care decisions; or an expression of preferences about health care decisions; may take one of the following forms: a written document, voluntarily executed by an adult in accordance with the requirements of this chapter; or a witnessed oral statement, made in accordance with the requirements of this chapter; and does not include a life with dignity order (§ 75-2A-103(2)).
Signing Requirements – The form must be witnessed by a “disinterested adult”, as mapped out in the language of the Utah Uniform Probate Code § 75-2A-107(c).
Revocation – (§ 75-2A-114)
Other Versions (6)
- Version 1
- AARP (Caring Connections)
- Five Wishes (Aging with Dignity)
- Prepare for Your Care
- Spanish Version
- Utah Catholic
Utah Advance Directive Form Version – 1
Download: Adobe PDF
AARP (Caring Connections) Version
Download: Adobe PDF
Instructions: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF
Instructions: Adobe PDF
Download: Adobe PDF
Guide: Adobe PDF
Additional Resources
- Bradford Law Office – Elder Law – Utah Advance Health Care Directive
- Intermountain Healthcare – Advance Directive
- Leaving Well Utah – Advance Directives
- Leaving Well Utah – Health Care Power of Attorney
- Leaving Well Utah – Physician Order for Life-Sustaining Treatment (POLST)
- Molina Healthcare – Advance Directives Information Sheet
- Utah Commission on Aging – Tool Kit for Advance Care Planning
Related Forms (4)
- Advance Directive for Mental Health
- Advance Directive Wallet Card
- Durable (Financial) Power of Attorney Form
- POLST Form
Advance Directive for Mental Health
Download: Adobe PDF
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
POLST (Physician Orders for Life-Sustaining Treatment) Form
Download: Adobe PDF
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