![](https://laborcommission.utah.gov/wp-content/uploads/2018/09/Form001f.png)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form024f.png)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form025f.png)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/09/Form026f.png)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/09/Form027f.png)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/summary-of-medical-record-industrial-accident-3.10.png)
113a Summary of Medical Record – Industrial Accident
(or you may submit actual medical records supporting your claim)
(or you may submit actual medical records supporting your claim)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/summary-of-medical-record-occupational-exp-3.10.png)
113b Summary of Medical Record – Occupational Exposure
(or you may submit actual medical records supporting your claim)
(or you may submit actual medical records supporting your claim)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form-152.png)
152 Appointment of Counsel
(optional)
(optional)
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/307-List-of-Providers-01-06-2021.png)
307 Medical Treatment Provider List
Notes on form 307… ipsum dolor etc
Notes on form 307… ipsum dolor etc
![Form 308 - 15 years](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form-308.png)
![Form 308 - 15 years](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form-308.png)