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.
Instructions – Adobe PDF
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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