Revocation of Advance Health Care Directive - Utah

Utah · Fillable PDF · Free

Use this form to cancel a Utah advance health care directive, including any power of attorney for health care, or an advance mental health care directive. Use this form to cancel a Utah advance health care directive, including any power of attorney for health care, or an advance mental health care directive.

Download Revocation of Advance Health Care Directive - Utah PDF · 3 pages. No account required.

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Who this form is for

For Utah residents and families: revocation of 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

Identify the documents (Page 1) Check each document you are revoking and enter its date and agent names.
Sign before a notary (Page 2) Under Utah law, you may revoke a directive at any time while you have capacity. A notarized revocation gives clear proof of the date and your identity. Bring a current, government-issued photo ID.
Notify your doctors and agents (Page 2) Give copies to your doctor, hospital, and each agent named, and record each notice.

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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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