Form 221B Restorative Services Authorization/Denial - Upper Extremity - Utah

What Is Form 221B?

This is a legal form that was released by the Utah Labor Commission - a government authority operating within Utah. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on October 1, 2019;
• The latest edition provided by the Utah Labor Commission;
• Easy to use and ready to print;
• Quick to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of Form 221B by clicking the link below or browse more documents and templates provided by the Utah Labor Commission.