Utah Labor Commission Forms

This document is used for submitting a variance request for elevators or escalators in Utah. Users can seek permission for modifications or exemptions from the standard regulations.

This form is used for reporting confidential information on possible wrongdoing or misconduct in Utah.

This type of document is used to apply for a Certificate of Competency in Utah.

This Form is used for requesting an inspection of a new elevator in Utah.

This document is a cover sheet for a special design plan in Utah. It provides an overview of the plan and includes important information such as project details and contact information.

This Form is used for the renewal application of self-insurance in Utah.

This form is used for employees in Utah who need to notify their employer about their intention to leave the locality or state, as well as their decision to change their doctor or hospital.

This form is used for employees in Utah to notify them of the denial of their claim.

This form is used for reporting an injury and providing information about the total losses incurred as a result. It is specific to the state of Utah.

This form is used for submitting a physician's statement in the state of Utah. It is required for certain insurance claims or disability benefits.

This Form is used for authorizing or denying restorative services for upper extremity injuries in the state of Utah.

This Form is used for reporting cases of emergency medical service providers being exposed to potentially harmful substances or infectious diseases in Utah.

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 document is used for creating a profile for electronic trading partners in the state of Utah. It helps in establishing electronic communication and collaboration between businesses.

This document is used for creating an electronic partnering agreement in the state of Utah. It outlines the terms and conditions of a partnership between two or more parties, and allows for electronic signatures to be used for binding the agreement.

This form is used for contacting the workers' compensation carrier in Utah.

This type of form is used for assigning a wage claim in the state of Utah.

This document is used to gather information about wage claims in the state of Utah.

This document is used for the intake questionnaire regarding the prohibition of vaccine passports in Utah.