Agent Designation
Name the primary health care agent, describe their decision authority, and include alternates. Specify whether the agent may access medical records and make treatment, admission, or discharge decisions on your behalf.
A directive documents preferences, names a trusted decision-maker, and reduces uncertainty for family and clinicians. It preserves patient autonomy, helps healthcare teams follow lawful instructions, and can prevent emotionally charged disputes if incapacity occurs.
People who prepare a Utah Advance Health Care Directive range from those with chronic illness to adults planning for future incapacity.
An adult who anticipates possible incapacity or wishes to document treatment preferences. The principal specifies the scope of authority, limits, and any advance instructions; accurate identification and clear language reduce ambiguity and support enforceability.
A trusted individual chosen to receive medical information and make health decisions when the principal lacks capacity. The agent should understand the principal’s values and be reachable; naming alternates is recommended if the primary agent is unavailable.
Name the primary health care agent, describe their decision authority, and include alternates. Specify whether the agent may access medical records and make treatment, admission, or discharge decisions on your behalf.
Provide clear, actionable directions about resuscitation, mechanical ventilation, hydration, antibiotics, and palliative care. Use unambiguous phrases and examples to reduce clinical interpretation gaps.
Include explicit authorization for providers to disclose protected health information to the agent. A HIPAA release ensures the agent can obtain records needed to make informed decisions.
State your preferences for organ or tissue donation, whether for transplant, research, or education. Be specific about timing and any restrictions on donation.
Record the execution date, signatures, witness names, and notary acknowledgment if used. These details support legal validity and streamline access during clinical emergencies.
Provide space to add or revoke instructions, name replacement agents, and indicate effective dates for changes. Note that updated versions should replace prior copies.
| Field | Configuration |
|---|---|
| Authentication | Email link; optional SMS code or KBA |
| Signature Type | Typed, drawn, or cryptographic digital signatures allowed |
| Witness Fields | Add two witness signature fields or notary block |
| Audit Trail | Capture timestamp, IP, and signer identity |
Digital completion requires PDF or DOCX formats, secure transmission, and signer authentication to meet legal and clinical needs.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | 7-day free trial | No | No | Yes, limited | Yes, limited |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |