Advance Health Care Directive - Utah

Utah · Fillable PDF · Free

This is Utah’s official optional form under the Uniform Health Care Decisions Act (effective January 1, 2026). It names an agent to make health care decisions if you cannot, and records your wishes about treatment and organ donation. This is Utah’s official optional form under the Uniform Health Care Decisions Act (effective January 1, 2026). It names an agent to make health care decisions if you cannot, and records your wishes about treatment and organ donation.

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Who this form is for

For Utah residents and families: advance health care directive.

What you'll need

Read the supplied packet before filling in its fields.
Follow this document's signing, identification, witness and filing instructions.

How to complete it

Name an agent (Page 1) Name an agent and an alternate. You may limit their authority. Any item may be left blank.
Give instructions (Pages 2–5) Mark or initial your choices about life-sustaining treatment, food and liquids, pain relief, and your priorities.
Special powers and donation (Pages 5–7) Initial any special powers, guardian nomination, and organ donation choices.
Sign with a witness (Page 7) If you name an agent, Utah requires one adult witness who is not your agent, the agent’s spouse or partner, or (in a nursing home) staff or owners. We also recommend the optional notary acknowledgment on Page 8, and can provide a witness for an additional fee.

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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