152 Appointment of Counsel
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form-152.png)
152 Appointment of Counsel
(optional)
(optional)
024 Medical Care Provider
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form024f.png)
025 Industrial Accident Claim
![](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form025f.png)
113b Summary of Medical Record – Occupational Exposure
![](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)
026 Occupational Disease Claim
![](https://laborcommission.utah.gov/wp-content/uploads/2018/09/Form026f.png)
113a Summary of Medical Record – Industrial Accident
![](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)
308 Authorization to Release Medical Records (10 Years)
![Form 308 - 15 years](https://laborcommission.utah.gov/wp-content/uploads/2018/08/Form-308.png)
001 Industrial Accident Claim
![](https://laborcommission.utah.gov/wp-content/uploads/2018/09/Form001f.png)