Form · Advance care · UT

Utah advance directive form

The state's own form, from Utah State Legislature (Utah Code). Rivvi links it; we do not host or change it. Not legal advice.

Quick answer

Utah's advance directive form is the Advance Health Care Directive (Utah Code 75A-9-110 Optional form), from Utah State Legislature (Utah Code). The same form includes the part that names a health care agent (medical power of attorney). Open the state form

Run it in Rivvi

Understand Utah's advance directive form

Ask Rivvi

Free to start, no card. Opens Rivvi, the AI workspace for healthcare teams, with this question filled in.

The state form

Form: Advance Health Care Directive (Utah Code 75A-9-110 Optional form)
Publisher: Utah State Legislature (Utah Code)
Law: Utah Code § 75A-9-110 (Uniform Health Care Decisions Act, effective 1/1/2026)
Form link: le.utah.gov/xcode/Title75A/Chapter9/C75A-9_2026010120250507.
Names a health care agent: Yes, in the same form
Signing (per the source): Form: a witness is needed if using the form to name an agent; the witness must be an adult and not the agent or the agent's spouse/partner (extra rule for nursing-home residents)
Link checked: October 23, 2026

Questions

Where do I get Utah's advance directive form?

Utah State Legislature (Utah Code) publishes it: Advance Health Care Directive (Utah Code 75A-9-110 Optional form). The link on this page goes to the state's copy (checked October 23, 2026).

Does Utah have a medical power of attorney form?

The same form includes the part that names a health care agent (medical power of attorney).

Does a Utah advance directive need witnesses or a notary?

Per the state source: Form: a witness is needed if using the form to name an agent; the witness must be an adult and not the agent or the agent's spouse/partner (extra rule for nursing-home residents). Read the form's own signing instructions before you sign.