Utah Advance Health Care Directive Form

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Get your Utah Advance Health Care Directive Form in 3 easy steps

  • 01 Fill and edit template
  • 02 Sign it online
  • 03 Export or print immediately

1. What is a Utah Advance Health Care Directive Form?

Utah Advance Health Care Directive Form is used for legal selecting of a person (agent), who will make health decisions if a person loses an ability to do it due to a health condition. Your primary care physician, family, and agent must keep copies of the document as long as needed. The agent must be able to prove his/her identity.

2. What I need the Utah Advance Health Care Directive Form for?

  • You have to fil out and sign the fillable Utah Advance Health Care Directive Form if you see prospects to lose the ability to make healthcare decisions with your own words;
  • Fill to renew the old directive;
  • Don’t feel out the form if there’s no perspective to need it. Usually, your doctor will advise you to submit it if needed. 

If you need to download the Utah Advance Health Care Directive Form, you can get a PDF version on our website.

3. How to fill out Utah Advance Health Care Directive Form?

There are 4 pages in this form:

  • Enter your name, address, contacts, and other personal info;
  • Part I – state whether you want an agent or not and provide the information about your agent if your answer is positive. An alternative agent can be appointed as well;
  • You can allow/prohibit your agent(s) to get copies of medical care documents and admit you to health care facilities. You can additionally limit or extend the agent’s authority;
  • Agree/disagree with taking part in medical research and the organ donation program. 
  • Part II – declare and specify your health care wishes;
  • Read part III;
  • Part IV – fill together with a witness to legalize the directive. 

4. Organizations that work with Utah Advance Health Care Directive Form:

  • Health Care Organizations of Utah
Fillable online Utah Advance Health Care Directive Form
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