1. (1) Each affidavit of merit signed by a health care provider as required by Subsections 78B-3-423(1) and (2)(b) shall include the following text immediately prior to the affiant's signature:

   TABLE VI

   I hereby certify that I am an appropriate health care provider

   qualified to render an affidavit of merit in this medical

   malpractice case as specified by Utah Code Subsection 78B-3-423(4).

   My license class and professional specialty are: (describe).

   I further certify that I have reviewed the medical records and

   other relevant material involved in this medical malpractice case

   and have determined that:

2. (1) In my opinion, there are reasonable grounds to believe

   that the applicable standard of care was breached by the following

   respondent(s): (identify by name each respondent included in the

   affidavit).

3. (2) In my opinion, the breach was a proximate cause of the

   injury claimed in the notice of intent to commence action.

4. (3) The specific reasons for my opinion are (explanation for

   each respondent named in the affidavit).

5. (2) As provided by Subsection 78B-3-423(3), the statement that there are reasonable grounds to believe that the applicable standard of care was breached shall be waived if the claimant received an opinion that there was a breach of the applicable standard of care under Subsection 78B-3-418(2)(a)(i).

KEY: medical malpractice, prelitigation, certificate of compliance, affidavit of merit

Date of Last Change: December 10, 2018

Notice of Continuation: January 3, 2022

Authorizing, and Implemented or Interpreted Law: 78B-3-416(1)(b)