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Utah Advance Directive Form

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 Utah Commission On Aging)

Remember to add your completed form to your Everplan!

See our complete list of resources for Utah.

  • State-By-State Resources
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