Utah Advance Directive Form (Medical POA + Living Will)

A Utah advance directive is a document that overviews a person’s healthcare and end-of-life wishes should they become incapacitated. The form provides instructions for the patient’s medical team and designates a healthcare agent who assumes decision-making powers. The agent’s powers and medical directives only initiate when the principal is no longer of sound mind.

Laws

Statutory Form§ 75-2a-117

Signing Requirements (§ 75-2a-107(c)) – One (1) disinterested witness.

State Definition (§ 75-2a-103(2)) – “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.

Spanish (Español) VersionAdobe PDF

Versions (3)


blankAARP

Download: Adobe PDF

 

 

 

 


blankIntermountain Healthcare

Download: Adobe PDF

 

 

 

 


blankCatholic Diocese of Salt Lake City

Download: Adobe PDF