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Free Fillable Utah Medical Power of Attorney Form

A Utah medical power of attorney form is a vital document that allows an individual to delegate power to another entity to make crucial decisions upon incapacitation. The advance directive agreement allows you to select a trusted person to be your decision-maker and liaise with your attending physician to consent to your treatment preference. After you sign the power of attorney form, you must make copies and distribute them to your private attorney, family members, and primary doctor.

The principal is the form’s creator, and the health care agent accepts to become the sole decision-maker.

Utah power of attorney forms – read more about powers of attorney for different property types in the State of Utah.

Utah Requirements

The Utah power of attorney agreement is a powerful legal document that must comply with the state legislation. As per the Utah statute, Title 75, Chapter 2a (Advance Health Care Directive Act), any adult of sound mind can create a POA agreement and choose to assign a health care agent or not.

Utah state accepts both oral and written advance medical directives from the principal. Also, the form requires at least one witness to validate the agreement. However, the witness must be a neutral person and not have blood or marriage ties to the principal. They must not be an agent or an heir to the principal’s estate.

Read the above link to have an in-depth understanding of the laws concerning a Utah power of attorney document.

Filling Out The Utah Medical POA

Writing a Utah medical power of attorney form is a process that entails filling out personal details of all the people involved in fulfilling this agreement. It is essential to understand the POA completion process for easy access and creation. As per Utah state laws, the principal must append their signature and include a witness for validation purposes. Below are steps to fill the POA form:

Obtain the Form

You can use the free medical POA free templates on our site to generate a high-quality agreement. Download the proper document and print it or use it on a soft copy on your computer. However, make sure it is similar to the recommended state-provided form.

Principal and Health Care Agent Particulars

The next step is to enter the details of all the parties involved. As the principal, you need to fill out particulars on the table categorized as “my personal information.” Here, you must include all your details, such as full name, physical address, city, state, telephone number, and birth date.

You also need to select a health care agent and fill out his particulars on the form, the same as the principal’s details. Furthermore, you have an option to add an alternate health care agent in case the initial person backs out due to various reasons.

Ensure that you select a reliable individual with discipline, able to act within your directives without malice or other ill intentions.

List Your Directives

The principal must clearly state the action that the health care agent must execute fully. There are several “yes” or “no” statements that the principal must tick on the form as part of the process.

The document allows you to list all the limitations that guide the agent in consenting to specific treatment preferences. While selecting a guardian is not necessary, you have an option to tick a box to acknowledge that your agent can serve as your guardian.

Moreover, the principal can also consent to medical research or organ donations upon death in this section.

Document a Living Will

As per Utah state laws, the principal can include a living will with declarations and directives for the agent to execute in case of incapacitation or a serious medical procedure. For instance, the principal can choose to go for the agent’s decision or allow the attending doctor to incorporate life-prolonging mechanisms. Otherwise, they may opt not to receive any treatment at all for sustaining life.

The POA creator may not choose any default option on the form and may add other additional directives about their health care wishes.

Principal and Witness Signatures

Finally, you can get at least one witness to sign the POA document to validate the agreement. Both the principal and the witness must include their full name, city, county, state, signature, and current date.

Other Utah Forms By Type

Other Medical Power of Attorney Forms By State