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This form is used to nominate someone for a commendation or award in the state of Utah.
This document provides statistics and information about the enforcement of overtime violations involving pedestrians and bicycles in Utah. It includes data on the number of violations, enforcement actions taken, and related details.
This form is used for acknowledging participation in the telework program in Utah.
This Form is used for the State-Provided Cell Phone Agreement in Utah.
This form is used for personal cell phone allowance agreement in the state of Utah.
This document is a form used in Utah for the purpose of entering into an education assistance agreement.
This form is used for agreeing on compensation for permanent partial disability in Ohio. It helps establish the amount of compensation that will be paid to an individual who has suffered a permanent partial disability.
This form is used for applying for compensation for permanent total disability in the state of Ohio.
This form is used for acknowledging and waiving the settlement in the case of a work-related death in Ohio. It signifies the final agreement between the parties involved.
This form is used for authorized representatives in Ohio to apply for electronic funds transfer or direct deposit.
This form is used for audiologists in Utah to apply for a harp license.
This form is used for applying for a Harp Child program in Utah. It is designed for parents or guardians to enroll their child in this specific music education program.
This Form is used for requesting prior authorization for medical services or treatments in the state of Utah. It helps ensure that the requested service is medically necessary and covered by the insurance provider.
This form is used for confirming a diagnosis of Autism Spectrum Disorder (ASD) in the state of Utah.
This form is used for requesting prior authorization for hospice services in the state of Utah.
This document is for conducting an independent physician review for extended care at a hospice facility in Utah.
This Form is used for requesting prior authorization for Applied Behavior Analysis (ABA) services in Utah.
This document is a Functional Assessment for a Personal Care Agency in Utah. It helps assess the functional needs of individuals requiring personal care services.
This Form is used for requesting prior authorization for home health and personal care services in Utah.
This Form is used for requesting prior authorization for genetic testing in the state of Utah.
This form is used for conducting the final evaluation of a wheelchair in Utah. It helps assess the functionality and suitability of the wheelchair for the user.
This type of document is a training checklist specifically for power wheelchair training in the state of Utah.
This form is used for obtaining consent for sterilization procedures in the state of Utah. It is available in both English and Spanish languages.
This Form is used for requesting prior authorization for inpatient intensive physical rehabilitation in the state of Utah.
This form is used for adding an addendum to a property purchase contract in Texas when the property is subject to mandatory membership in a property owners association.
This form is used for requesting prior authorization for mental health residential treatment services for individuals aged 21-64 in Utah.
This Form is used for requesting prior authorization for enteral formula in the state of Utah.
This form is used for requesting prior authorization for individuals aged 21-64 who require psychiatric hospital inpatient services in the state of Utah. It helps ensure that the necessary care and treatment are provided to patients in need.
This document is used for determining the criteria for prior authorization of personal care services in Utah.
This document is a contract used in Texas for the sale of a newly constructed home.
This document is an addendum used in Texas for fixture leases.
This document is used for filing a complaint related to civil rights in the state of Utah. It provides a formal process for individuals to report and address any violations of their civil rights that may have occurred.