Substance Use Disorder Residential Treatment Services Prior Authorization Request Form - Utah

Substance Use Disorder Residential Treatment Services Prior Authorization Request Form is a legal document that was released by the Utah Department of Health and Human Services - a government authority operating within Utah.

Form Details:

• Released on December 1, 2021;
• The latest edition currently provided by the Utah Department of Health and Human Services;
• Ready to use and print;
• Easy to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Utah Department of Health and Human Services.