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Printable Resources

Advance Directives

Here you can find all the printable resources from the site, to make it easy to share them with patients and caregivers.

Utah State Advance Directive Form
This is the current, legal Utah Advance Directive form. People of all ages should have an Advance Directive, to help ensure that their health care wishes are carried out in the event of incapacity. The form includes the ability to describe preferences for life-sustaining treatment and to designate a health care agent.

Electronic Utah State Advance Directive Form
Download an electronic version of the Advance Directive form that can completed online.

Spanish Version of the Utah State Advance Directive Form
Download and print a Spanish translation of the Advance Directive form. Thanks to Intermountain Healthcare for this translation.

Wallet-sized Advance Directives Notification Card
This convenient card lets health care workers know that a person has an Advance Directive. The card also includes family contact names and numbers.

Find out more

PDFicon.png End of Life Care in Utah

View a report on the state of end-of-life care in Utah. 

If you are interested in joining the Leaving Well Coalition or learning more about us, contact: 
eolwebmaster@healthinsight.org

To learn more about ePOLST, also contact: 
eolwebmaster@healthinsight.org