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Utah is one of only eight states in the nation that require you to take an additional step after you've completed your Five Wishes. State law mandates you use a government-approved form and words to express your own wishes. You can download the state form here as a PDF or talk to your doctor.

Download English Form

Download Spanish Form

  • Used by more than 30 million families and 40,000 organizations
  • Bilingual EditionsAvailable in 29 languages and in Braille
  • Download NowA free guide on how to talk with a loved one about their healthcare choices.
  • Sample Five WishesSee a sample of Five Wishes.