All Government Forms in Utah

Form Title	Agency	Jurisdiction
2019 Medical Fee Standards	Department of Labor Commission	Utah
2019 Workers’ Compensation Payment Grid	Department of Labor Commission	Utah
2019 Workers’ Compensation Quick Reference Guide	Department of Labor Commission	Utah
2021-Negotiated-Agreement-Final	Utah Schools for the Deaf and Blind	Utah
307 Medical Treatment Provider List	Department of Labor Commission	Utah
307 Medical Treatment Provider List	Occupational Safety & Health	Utah
308 Authorization to Release Medical Records	Department of Labor Commission	Utah
308 Authorization to Release Medical Records (10 Years)	Occupational Safety & Health	Utah
308 Authorization to Release Medical Records (15 years)	Occupational Safety & Health	Utah
30 Day ATMS BURN-IN TEST REPORT	Department of Transportation	Utah
3rd Party Release Form	Occupational / Professional Licensing	Utah
402 Application for Hearing – Termination or Reduction of Compensation	Department of Labor Commission	Utah
402 Application for Hearing – Termination or Reduction of Compensation	Occupational Safety & Health	Utah
403 Persons with Knowledge List	Department of Labor Commission	Utah
403 Persons with Knowledge List	Occupational Safety & Health	Utah
404 Notice of Filing “Application for Hearing for Termination or Reduction of Benefits”	Department of Labor Commission	Utah
404 Notice of Filing “Application for Hearing for Termination or Reduction of Benefits”	Occupational Safety & Health	Utah
502 Application for Hearing Failure of Diligent Pursuit	Department of Labor Commission	Utah
502 Application for Hearing Failure of Diligent Pursuit	Occupational Safety & Health	Utah
5 Day - Request for Testing Notification	Department of Transportation	Utah