Utah Advance Directive Form (Medical POA & Living Will)

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The Utah Advance Directive compiles a thorough written record to store information concerning an individual’s desires for health care treatment preferences. The format of the advance directive combines a medical power of attorney with a living will to capture a complete comprehension of the patient’s wishes. Within the paperwork’s contents are sections for the declarant designed to ascertain an understanding of how and what they would like to see occur should they become unable to communicate their own decisions at a future time. The registry aims to establish defined paths to take in preparing for unforeseeable events, including the assignment of a chosen person to take on the role of an attorney-in-fact. The nominated agent will be given the responsibility of making decisions on behalf of the principal in cases where they become incapacitated. Endorsement of the document will require the assistance of an acceptable witness to instate the contract.

Other Versions (6)

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

 

 

 


Spanish Version

Download: Adobe PDF
Instructions: Adobe PDF

 

 


Utah Catholic Version

Download: Adobe PDF
Guide: Adobe PDF

 

 

Additional Resources

Related Forms (4)

Advance Directive for Mental Health

DownloadAdobe PDF

 

 

 


Advance Directive Wallet Card

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