Utah Advance Directive Form

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Below is the information you'll need in order to obtain an Advance Directive in Utah.

Overview: The Utah Living Will is called "My Health Care Wishes" and is included in an Advance Directive packet that also contains a form for naming a "Healthcare Power of Attorney" (a.k.a. Health Care Proxy) and specifying Organ Donation.

Required Information: You and one (1) witness must sign your UT Advance Directive for it to be considered valid. The witness CAN NOT be:

  • Related to the declarant by blood or marriage
  • Entitled to any portion of the declarant's estate according to the laws of intestate succession of any state or jurisdiction or under any will or codicil of the declarant
  • A beneficiary of a life insurance policy, trust, qualified plan, pay on death account, or transfer or death deed that is held, owned, made, or established by, or on behalf of, the declarant
  • Entitled to benefit financially upon the death of the declarant
  • Entitled to a right to, or interest in, real or personal property upon the death of the declarant
  • Directly financially responsible for the declarant's medical care
  • A health care provider who is providing care to the declarant or an administrator at a health care facility in which the declarant is receiving care
  • The appointed agent or alternate agent

Download the Utah Advance Directive Form Here
(Via The University of Utah Center On Aging)

Remember to add your completed form to your Everplan!

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Advance Directives