Utah Do Not Resuscitate (DNR) Form

Utah Do Not Resuscitate (DNR) Form

Utah do not resuscitate form is a medical order used to tell health care providers not to attempt to revive a patient if they have no pulse and are not breathing. Utah uses the Provider Order for Life-Sustaining Treatment (POLST) form, which contains a DNR and other preferences for life-sustaining treatments. A patient can revoke a Utah POLST at any time.

Last updated July 6th, 2025

Utah do not resuscitate form is a medical order used to tell health care providers not to attempt to revive a patient if they have no pulse and are not breathing. Utah uses the Provider Order for Life-Sustaining Treatment (POLST) form, which contains a DNR and other preferences for life-sustaining treatments. A patient can revoke a Utah POLST at any time.

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Signing Requirements

The Utah POLST form must be signed by the patient and a health care provider.[1]

Two medical healthcare providers must sign the document for pediatric patients.

Sources

  1. § 75a-3-106