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Utah Advance Health Care Directive
Support GuideUtah28 min read

Utah Advance Health Care Directive

A Utah advance health care directive now runs on Title 75A Chapter 9. One adult witness, no notary, and a health care instruction needs nothing in writing.

By Settled Editorial

A Utah advance health care directive is a power of attorney for health care, a health care instruction, or both. The rules live in the Uniform Health Care Decisions Act at Utah Code Title 75A, Chapter 9, sections 75A-9-101 through 75A-9-129, in force since 1 January 2026. Naming an agent takes your signature and one adult witness. No notary. Recording your wishes takes no signature at all.

Read this as a plain map of the statute, then have a Utah attorney draft or review what you sign. It is not legal advice.

The Law Moved, and Most Utah Advice Has Not Caught Up

Utah used to run advance directives out of the Advance Health Care Directive Act at Title 75, Chapter 2a. That chapter was renumbered out of Title 75 on 1 September 2024, and Title 75 no longer lists a Chapter 2a at all. Its live chapters run 1, 2, 2b, 3, 4, 5, 5b, 6 and 13.

The act that replaced it is the Utah Uniform Health Care Decisions Act, enacted by Chapter 439 of the 2025 General Session and effective 1 January 2026. Anything you read that cites 75-2a-101 through 75-2a-125 is describing law Utah no longer has. The same goes for the widely circulated four-part "Utah Advance Health Care Directive" that printed "Pursuant to Utah Code Section 75-2a-117" across its header, ran Part I agent, Part II wishes, Part III revocation and Part IV signatures, and carried an end date of 1 May 2024. Check the citation before you trust the article, the form, or the witness rules attached to either.

Your existing paperwork is fine. Section 75A-9-128(1) keeps a directive created before 1 January 2026 valid if it complies with Chapter 9 or complied at the time you created it with the law of the state where you created it. What changed is the rulebook, not your document.

Utah Recognizes Four Instruments

"Advance health care directive" is the umbrella term. Utah Code 75A-9-101(1) defines it as a power of attorney for health care, a health care instruction, or both, and folds in the advance mental health care directive.

DocumentWhat it doesHow you execute itStatute
Power of attorney for health careAppoints an agent to make health care decisions for youIn a record, your signature, one adult witness75A-9-107
Health care instructionRecords your goals, preferences and wishes about treatmentNo formality at all, and it may be spoken75A-9-106, 75A-9-101(12)
Advance mental health care directiveCovers mental health care only, and may hold either piece or bothSame rules as the piece it uses75A-9-108
Order for life sustaining treatmentA portable medical order directing providers, facilities and ambulance crewsPrepared and signed by a clinician, plus you or your surrogate26B-2-802

The first two are the planning documents you sign while healthy. The order for life sustaining treatment arrives later, with serious illness, because a physician, advanced practice registered nurse or physician assistant has to sign it.

Signing the Power of Attorney for Health Care

Utah Code 75A-9-107(4) states the whole execution rule in one sentence. The document must be in a record, signed by you, and signed by an adult witness.

That witness has to reasonably believe your act of creating the power of attorney is voluntary and knowing. Three people are shut out under 75A-9-107(4)(b):

  • the agent you appointed,
  • the agent's spouse or cohabitant, and
  • if you live in or are receiving care at a nursing home or assisted living facility, an owner, operator, employee or contractor of that facility.

Utah's current act bars nobody else. A relative may witness. An heir may witness. Somebody who pays for your care may witness. The longer disqualification list that appears in older Utah forms belongs to the repealed chapter, so a template built on it asks you to hunt for a witness the statute never required.

Two more details make signing easier than most people expect. Under 75A-9-107(5) a witness counts as present in the same room, over a real-time audio and video connection, or over audio alone where the witness personally knows you or can authenticate you from accurate answers you give. And under 75A-9-107(4)(c) the witness may sign either when you sign or when you later represent that the document reflects your wishes, so the two signatures do not have to happen at the same moment.

Electronic paperwork holds up. Section 75A-9-115(3) says a directive, a revocation, or a signature on either may not be denied legal effect solely because it is electronic, and 75A-9-115(5) leaves Utah's Uniform Electronic Transactions Act intact. Section 75A-9-124 gives a physical or electronic copy the same effect as the original, and lets you certify a paper copy of an electronic directive by affirming under penalty of perjury that the copy is complete and accurate.

Two people are also barred from serving as your agent once you lack capacity, under 75A-9-107(2): anyone a court has found to pose a danger to your well-being, and an owner, operator, employee or contractor of the nursing home or assisted living facility where you live or receive care, unless that person is your family member, your cohabitant, or the cohabitant's descendant.

A Health Care Instruction Needs Nothing in Writing

This is the single biggest gap between Utah and a typical living-will state, and it is easy to state backwards.

Utah Code 75A-9-101(12)(a) defines a health care instruction as "a direction, whether or not in a record," that indicates your goals, preferences or wishes about providing, withholding or withdrawing health care. Section 75A-9-106 then adds no signature requirement, no witness requirement, no notarization and no writing requirement. Telling your oncologist what you want is a health care instruction under Utah law.

The clinician who receives it carries the paperwork duty instead. Under 75A-9-106(2) that professional must document the instruction and its date in your medical record, or pass it to the records administrator, who documents it. Providers must then comply with it under 75A-9-120(5)(a).

Write it down anyway. A spoken instruction is legally good and evidentially fragile, because it survives only as somebody's chart note. Section 75A-9-106(4) lets a written instruction share one record with your power of attorney for health care, and 75A-9-107(6) says the power of attorney may contain the instruction, so one signed document can carry both.

Section 75A-9-106(1) lists what an instruction may cover: which professionals and facilities you want, how a decision gets made and communicated, who should and should not be consulted, who should serve as your guardian if a court appoints one, and who should serve as your default surrogate. A later instruction, including one written into a medical order, revokes an earlier one to the extent they conflict (75A-9-106(3)).

Utah Prints an Optional Form

Section 75A-9-110 is headed "Optional form," and its lead-in reads: "The following form may be used to create an advance health care directive." The form runs six parts.

  1. Part A names an agent and an alternate agent, and lets you carve limits out of the agent's authority.
  2. Part B records your instructions on life-sustaining treatment, on food and liquids given by tube, and on pain relief that may shorten life, plus a set of priorities such as staying alive with physical or mental limitations, freedom from pain, and independence.
  3. Part C holds optional special powers: voluntary admission to a mental health facility for a stated number of days, nursing home placement beyond 100 days, health information access at any time rather than only after you lose capacity, permission for the agent to apply your instructions flexibly, and a nomination of guardian.
  4. Part D covers organ donation and the purposes you allow.
  5. Part E carries your signature and the one witness signature.
  6. Part F is written guidance for the person you named.

Using it is optional. A document that satisfies 75A-9-106 or 75A-9-107 works whatever its layout. The Department of Health and Human Services is directed to develop uniform instructions for this form under 26B-2-802(10)(a)(ii).

When Your Agent's Authority Starts

Utah does not gate an agent on a terminal condition or a persistent vegetative state. The trigger is capacity.

Section 75A-9-117(1)(a) starts the agent's power when you are found to lack capacity to make a health care decision, either under 75A-9-103(2) or by a court. Section 75A-9-117(3) lets your document flip that: a power of attorney for health care may provide that the agent's power commences on appointment, which is how you give somebody medical-records access today rather than after a crisis. Section 75A-9-117(2) is the records power itself, letting an agent request, receive, examine, copy and consent to disclosure of your health information wherever you could.

Getting to a finding of lack of capacity takes real work. You are presumed to have capacity under 75A-9-103(1). Rebutting that presumption needs a contemporaneous examination by a physician, a licensed psychologist, or a physician assistant or advanced practice registered nurse with training and expertise in finding lack of capacity (75A-9-103(2)(a)). Any other responsible health care professional may make the finding only where none of those is reasonably available and you have a condition requiring a prompt treatment decision to avoid loss of life or serious harm.

The finding has to be documented in a signed record that includes an opinion on the cause, nature, extent and probable duration of the incapacity (75A-9-103(2)(c)). It may not be made by your family member, your cohabitant or the cohabitant's descendant, or by your surrogate or the surrogate's family member or descendant (75A-9-103(3)).

You keep a right to argue. Under 75A-9-104(3) you may object orally, in a record, or by another act that clearly shows objection, and on objection you must be treated as having capacity unless you withdraw the objection, a court rules otherwise, you have a condition requiring a prompt decision to avoid imminent loss of life or serious harm, or a second independent finder confirms the first finding. Section 75A-9-104(5) closes the loop that matters most: a second confirming finding is not enough where you are asking for life-sustaining treatment to be provided or continued and the finding is being used to withhold or withdraw it.

Either way, 75A-9-105 lets you, a responsible health care professional, the institution treating you, or a person interested in your welfare petition the district court in the county where you live or are located. The court appoints counsel if you have none, hears the petition as soon as possible, and may find that you lack capacity only on clear and convincing evidence.

What Your Agent May Not Do

Your agent owes you a fiduciary duty under 75A-9-116(1) and must follow your directions and your known or reasonably ascertainable wishes. Only where no direction exists and your wishes are unknown does the agent fall back to your best interest, and even then 75A-9-116(4) says the agent must give first consideration to what you are communicating now, verbally or nonverbally.

Utah then puts four hard limits on top:

  • Mental health admission. An agent or default surrogate may not consent to voluntary admission to a mental health facility unless you specifically authorized it in a directive in a record, and then only for up to the number of days your directive names (75A-9-117(5)).
  • Long nursing home stays. No consent to a placement intended to run more than 100 days where a reasonably feasible alternative exists, where you object, or where you are not terminally ill, unless you specifically authorized it in a record (75A-9-117(6), (7)).
  • Routine life-sustaining treatment for a long-term disability. Where you have a long-term disability needing routine artificial nutrition, hydration or mechanical ventilation and a history of using it without objection, a surrogate may not consent to withholding or withdrawing it unless the treatment is not needed to sustain your life or well-being, you expressly authorized the withdrawal in an unrevoked health care instruction, or you have suffered a major reduction in health or functional ability from which recovery is not expected and have given no contrary direction (75A-9-118(1)).
  • Decisions courts reserve. A default surrogate may not make a decision that Utah law keeps from a guardian, or that a guardian may make only with specific court authorization (75A-9-118(2)).

If You Never Name an Agent

Utah supplies a surrogate rather than sending your family to court. Section 75A-9-111(1) lets a default surrogate decide for you when you lack capacity and no agent or guardian with health care authority has been appointed or is reasonably available. Section 75A-9-111(2) then ranks ten classes in descending order:

  1. An adult you identified, outside a power of attorney, to decide if you cannot.
  2. Your spouse, unless an annulment, divorce, dissolution, legal separation or termination petition has been filed and not dismissed or withdrawn, a decree has issued, you agreed in a record to a legal separation, or the spouse willfully deserted you for more than a year.
  3. Your adult child or parent, one shared class at one rank.
  4. Your cohabitant, meaning one of two people who lived together as a couple for at least a year after each became an adult or was emancipated and who are not married to each other (75A-9-101(5)).
  5. Your adult sibling.
  6. Your adult grandchild or grandparent, again one shared class.
  7. An adult not already listed who routinely helped you with supported decision making during the previous six months.
  8. An adult stepchild not already listed whom you actively parented as a minor and with whom you have an ongoing relationship.
  9. An adult not already listed who has shown special care and concern for you and knows your personal values.
  10. A physician designated under 75A-9-111(6).

Two features of that ladder catch people out. Children and parents sit together, so a Utah adult child holds no automatic edge over a surviving parent. And the whole list yields to your own document: 75A-9-111(2) applies only "unless the individual has an advance health care directive that indicates otherwise."

Anyone stepping into the role may be asked to back it up. Section 75A-9-111(3) lets a responsible health care professional require a declaration in a record, under penalty of perjury, stating facts sufficient to establish the authority, and directs the Department of Health and Human Services to create a uniform form for it. Refusing to give that declaration in time is itself a disqualification under 75A-9-113(2)(c). If a surrogate will not or cannot meet the 75A-9-116 duties, the professional may move to the next person in priority (75A-9-111(4)).

Disagreement inside one class goes to a majority, not to the next class down. Section 75A-9-112(2) tells the responsible health care professional to follow the majority of the highest-priority class members who have spoken and who appear to be meeting their duties. An even split sends the surrogate out to solicit views from class members who have not spoken, after which the professional follows the new majority (75A-9-112(3)). A class that stays evenly divided hands the decision to other Utah law (75A-9-112(4)).

When nobody can be found, 75A-9-111(6) lets the responsible health care professional designate a willing physician, but only after best efforts fail, only with the consensus of the institution's medical ethics committee or a similar body, only where that physician is not treating you, is not under the designating professional's authority, and is not that professional's family member or cohabitant, and only after you are told of the designation and your right to object.

Disqualifying Someone, and Revoking

You may knock a person off the surrogate ladder at any time. Section 75A-9-113(1) accepts a disqualification in a record you sign, or one communicated verbally or nonverbally to the person, to somebody else, or to a responsible health care professional. It works even if you no longer have capacity to make a directive, so long as you clearly communicate that you do not want that person deciding for you.

Revocation is just as loose. Section 75A-9-114(2) accepts any act that clearly indicates you intend to revoke an agent's appointment, a default surrogate's designation, or a health care instruction, including an oral statement to a health care professional. A later conflicting directive revokes the earlier one to the extent of the conflict (75A-9-114(3)). The only block is a court finding that you lack capacity to revoke, or a finding under 75A-9-103(2) confirmed after you objected (75A-9-114(1)).

Divorce works automatically. Under 75A-9-114(4), unless your directive says otherwise, naming your spouse as agent is revoked when an annulment, divorce, dissolution, legal separation or termination petition is filed and not dismissed or withdrawn, when a decree issues, when you agree in a record to a legal separation, or when the spouse has willfully deserted you for more than a year. The filing is enough, so the revocation lands long before the decree.

Guardianship does not override the document you signed. Section 75A-9-121(1) lets a guardian refuse to comply with or revoke your directive only where the appointing court expressly orders it, and 75A-9-121(2) says an agent's health care decision prevails over the guardian's unless a court orders otherwise. That is the clearest reason to sign a directive before anyone considers Utah guardianship.

Utah's POLST Analogue: the Order for Life Sustaining Treatment

Utah has one, and it lives outside Title 75A. Title 26B, Chapter 2, Part 8 carries the order for life sustaining treatment, sections 26B-2-801 and 26B-2-802. Section 26B-2-802 took effect on 1 January 2026, and the definitions at 26B-2-801 were amended again by Chapter 96 of the 2026 General Session, effective 6 May 2026.

It is a medical order rather than a planning document, and 26B-2-801(9) says it gives direction to health care providers, health care facilities and emergency medical services providers. Under 26B-2-802(2) it is prepared by your physician, advanced practice registered nurse or physician assistant, or by a supervised nurse, physician assistant, mental health professional or other provider designated by rule. Under 26B-2-802(3) it must be signed personally by that physician, advanced practice registered nurse or physician assistant, plus:

  • you, or an adult you direct to sign, if you are an adult with capacity;
  • the highest-priority surrogate under Section 75A-9-111, or a majority of that class, if you are an adult who lacks capacity; or
  • a parent or guardian, if the order relates to a minor.

An order that withholds or withdraws life sustaining treatment from a minor also needs a certification by two physicians that doing so is in the minor's best interest (26B-2-802(4)). The order goes on a form designated by the Department of Health and Human Services, states its date, and may set the level of life sustaining care or direct that it be withheld or withdrawn (26B-2-802(5)). Providers and ambulance crews get immunity for complying in good faith, and for giving life sustaining treatment when the order says to withhold it (26B-2-802(6)).

The order beats the directive. Section 26B-2-802(7) says that where the two conflict, the order for life sustaining treatment takes precedence. That is worth knowing before you sign one, because a clinician's order can quietly outrank the document you spent an afternoon on.

Revoking an order takes any of seven acts under 26B-2-802(8): telling emergency service personnel, writing "void" across the form, burning, tearing, destroying or defacing the form or a bracelet evidencing it, asking another adult to do any of that, signing or directing another adult to sign a written revocation, saying in front of an adult witness that you want it revoked, or completing a new order. A surrogate may revoke only consistently with the substituted judgment standard, only in writing or by completing a new order, and never between the moment an emergency service provider is contacted and the end of the emergency (26B-2-802(9)).

The form itself comes out of Department of Health and Human Services rulemaking under 26B-2-802(10)(a), so ask the clinician preparing your order for the current version rather than printing one off a private website.

When a Provider Refuses

Section 75A-9-120(5) requires a health care professional or institution treating you to comply with your health care instruction, with your surrogate's reasonable interpretation of it, and with your surrogate's decision made under Sections 75A-9-116 and 75A-9-117, to the same extent as if you had decided while you had capacity.

Refusal is allowed on five grounds under 75A-9-120(6): a timely-communicated institutional conscience policy, care that is not available to that professional or institution, care contrary to the professional's religious belief or moral conviction where other law permits refusal, care contrary to generally accepted health care standards, and compliance that would violate a court order or other law.

A refusal comes with duties. Under 75A-9-120(7) the professional or institution must tell you and your surrogate as soon as reasonably feasible, must immediately make a reasonable effort to transfer you to somebody who will comply, and must keep providing life-sustaining and comfort care until the transfer happens. Where the refusal rests on conscience, religion, professional standards or law, that care continues for at least 10 days after the refusal if transfer is reasonably believed impossible.

Section 75A-9-122 shields good-faith conduct on both sides, covering a professional who complies with a decision on a reasonable belief that the decider had authority, one who refuses on a reasonable belief that the decider did not, and an agent or surrogate acting in a good-faith effort to meet the 75A-9-116 duties.

Interfering With a Utah Directive Costs $25,000

Section 75A-9-123(1) bans four things: intentionally falsifying a directive; intentionally concealing, defacing, obliterating or deleting a directive or its revocation, or withholding knowledge of it from a treating professional, in order to frustrate your intent; coercing or fraudulently inducing you to create, revoke or refrain from either; and requiring or prohibiting a directive as a condition of providing health care.

The remedy is money. You or your estate may sue for statutory damages of $25,000 or actual damages, whichever is greater (75A-9-123(2)). A health care professional or institution that intentionally violates Section 75A-9-120 faces $50,000 or actual damages, whichever is greater, at the suit of the person who made the instruction or that person's estate (75A-9-123(3)), with a narrow carve-out at 75A-9-123(4) for an emergency medical services provider whose care was reasonably believed appropriate to avoid imminent loss of life or serious harm, met the standards of that profession, and did not begin in the facility where you live or were receiving care. A prevailing plaintiff recovers reasonable attorney fees, court costs and litigation expenses (75A-9-123(5)).

These are civil claims. Title 75A, Chapter 9 names no offense and sets no criminal penalty, so treat any article describing Utah directive interference as a crime with suspicion.

Three Things Utah's Act Does Not Do

No pregnancy exception. The word "pregnant" appears nowhere in Title 75A. Utah's act does not suspend a directive and does not restrict a surrogate's authority on account of pregnancy, so a Utah form carrying a pregnancy clause is borrowing it from somewhere other than Utah's statute.

No statutory registry. The word "registry" appears nowhere in Title 75A. The Department of Health and Human Services gets two form-related jobs in this area and no filing system: the default-surrogate declaration form under 75A-9-111(3)(b), and the order for life sustaining treatment form plus the uniform instructions under 26B-2-802(10)(a). So distribution is on you. Give copies to your agent, your alternate, your clinicians and the hospital you would likely use, and rely on 75A-9-124, which makes a copy as good as the original.

No authorization for assisted death. Section 75A-9-126(1) says the chapter does not authorize mercy killing, assisted suicide or euthanasia. Section 75A-9-126(3) does the opposite favor for your family: a death caused by withholding or withdrawing care in accordance with the chapter is not a suicide or a homicide, and does not impair or invalidate a life insurance policy or an annuity death benefit, whatever the policy says.

A Directive Signed in Another State

Section 75A-9-115(1) honors an out-of-state directive that complies with the law of the state named in the document or, where none is named, the state where you created it, or with Utah's Chapter 9. Section 75A-9-115(2) lets a person assume without inquiry that a directive is genuine, valid and still in effect, and rely on it, absent good cause to believe otherwise. Section 75A-9-126(5) then reads any directive under Utah law as of the time it is implemented, so a document written elsewhere gets Utah's meaning once Utah clinicians act on it.

Where This Sits in a Utah Plan

A health care directive covers medical decisions and nothing else. Utah Code 75A-2-103(2) excludes "a power to make health care decisions" from the financial power of attorney chapter entirely, and the statutory form at 75A-2-301 prints the same warning on its face: "This power of attorney does not authorize the agent to make health care decisions for you." You need both documents. Pair this page with the Utah power of attorney for money and property, and read Utah estate planning basics for the rest of the set. Everything here stops at death; from that point the Utah probate guide picks up.

Frequently Asked Questions

Does a Utah advance health care directive have to be notarized?

No. Utah Code 75A-9-107(4) asks for three things and nothing more: the power of attorney for health care must be in a record, signed by the individual creating it, and signed by one adult witness. The word notary does not appear anywhere in the Uniform Health Care Decisions Act, and the act offers no notarial substitute for the witness. Utah does require a notary for a financial power of attorney under 75A-2-105, which is a separate chapter and a separate document.

How many witnesses does a Utah advance directive need?

One. Utah Code 75A-9-107(4) calls for a single adult witness who reasonably believes your act of creating the power of attorney is voluntary and knowing. That witness may not be the agent you named, the agent's spouse or cohabitant, or, if you live in or are receiving care at a nursing home or assisted living facility, an owner, operator, employee or contractor of that facility. The old rule barring a relative or an heir from witnessing came from Utah's repealed Chapter 2a and is not the law today.

Does Utah have a living will?

Utah has no document called a living will. It has a health care instruction, defined at Utah Code 75A-9-101(12)(a) as a direction, whether or not in a record, that indicates your goals, preferences or wishes about providing, withholding or withdrawing health care. Section 75A-9-106 imposes no writing, signature, witness or notarization requirement on it, so a spoken instruction to a clinician counts. The clinician must then document the instruction and its date in your medical record under 75A-9-106(2).

Who decides for me in Utah if I never name an agent?

Utah Code 75A-9-111(2) sets a ten-class ladder of default surrogates in descending priority: an adult you identified outside a power of attorney, your spouse, your adult child or parent, your cohabitant, your adult sibling, your adult grandchild or grandparent, an adult who routinely helped you with supported decision making in the past six months, an adult stepchild you actively parented, an adult who has shown special care and concern and knows your values, and last a physician designated under 75A-9-111(6). Utah puts children and parents in one shared class, and grandchildren and grandparents in another.

What happens when family members in the same class disagree?

Majority rules, and the decision does not drop to the next class. Under Utah Code 75A-9-112(2) the responsible health care professional must follow the decision of a majority of the highest-priority class members who have communicated their views and who the professional reasonably believes are meeting their duties under Section 75A-9-116. If those who have spoken are evenly split, the surrogate must try to reach the class members who have not spoken, and the professional then follows the new majority. A class that stays evenly divided sends the decision to other Utah law under 75A-9-112(4).

Can my Utah agent move me into a nursing home?

Only within limits. Utah Code 75A-9-117(6) bars an agent or default surrogate from consenting to a nursing home placement intended to last more than 100 days if an alternative living arrangement is reasonably feasible, if you object, or if you are not terminally ill. Section 75A-9-117(7) lifts that bar only when you specifically authorized the placement in an advance health care directive in a record. Section 75A-9-117(5) applies the same pattern to a voluntary admission for mental health treatment, which needs your written authorization and a cap on the number of days.

Is my old Utah advance directive still valid?

Yes. Utah Code 75A-9-128(1) says a directive created before January 1, 2026 is valid if it complies with Chapter 9 or complied at the time you created it with the law of the state where you created it. Section 75A-9-128(2) leaves acts done before that date untouched, and 75A-9-129 applies the chapter to directives created before, on, or after January 1, 2026. You do not need to redo a Utah document that was properly signed under the old rules.

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Information current as of August 28, 2026

Settled Estate is not a law firm, and this content is for informational purposes only and does not constitute legal advice. Probate laws and procedures in Utah can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.

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