Fill and Sign Utah Legal Forms

This form is used for requesting authorization for medical treatment or for carriers to respond to such requests in the state of Utah.

This Form is used for reporting the initial reemployment of an injured worker by an insurer or employer in Utah.

This form is used for gathering information related to housing discrimination complaints in Utah. It is available in both English and Spanish. The questionnaire helps assess whether fair housing laws have been violated and aids in initiating a complaint process if necessary.

This Form is used for reporting the first injury or illness that occurred in the state of Utah.

This form is used for reporting compensation in the state of Utah. It provides a statement of income and wages received by an individual or business.

This form is used for authorizing or denying restorative services for spinal injuries in the state of Utah.

This Form is used for requesting documents from the local government in Utah.

This Form is used for reporting the suspension of benefits in the state of Utah.

This document is used for requesting a change to the date by which a violation must be fixed in Utah.

This form is used for requesting medical records in the state of Utah. It allows individuals to obtain their own medical records.

This document is a questionnaire used to gather information regarding employment discrimination cases in the state of Utah.

This Form is used for employees in Utah to request reimbursement from the Employers' Reinsurance Fund.

This form is used for requesting consultation and education services from Utah Occupational Safety and Health (UOSH) in the state of Utah.

This form is used for filing an amended employer's contribution report in the state of Utah.

This form is used for registering a business in the state of Utah. It collects information about the business and its owners.

This form is used for obtaining financial assistance for children with special health care needs in Utah.

This document is an application form for the Children's Hearing Aid Program (CHAP) in Utah. It is used by participants to apply for hearing aids for children.

This type of document is used for refusing a CCHD (Congenital Heart Disease) screening in Utah. It allows individuals to decline participation in the screening program.

This document is used to refer parents and infants to a program in Utah that provides support and resources for early childhood development.

This document is a referral for individuals in Utah to undergo a diagnostic audiological evaluation, which helps assess hearing loss and related issues.

This form is used for declining CMV testing in the state of Utah.

This form is used for granting authorization to disclose health information to other providers in the state of Utah.

This Form is used for referring patients to care coordination services in Utah. It helps facilitate communication and collaboration among healthcare providers to ensure patients receive appropriate and timely care.

This document is used to authorize the disclosure of health information to Health Clinics of Utah in the state of Utah.

This document is a consent form for telehealth services in the state of Utah. It also includes information about the notice of privacy practices and a financial agreement.

This form is used for giving permission to access and share medical records in Utah.

This document provides information about how your personal health information is protected and used by Family Dental Plan (FDP) and Health Clinics of Utah (HCU) in Utah. It explains your rights regarding your health information and how it may be shared.

This form is used for gathering medical information for individuals living in Utah. It helps healthcare providers assess a person's health status and make appropriate treatment decisions.

This document is used for obtaining consent for tele-intervention services in the state of Utah.

This Form is used for reporting health visit information in the state of Utah.

This form is used for determining the fees for family-related services in Utah.

This document is used for determining the family fee in Utah.