Workers’ Compensation Poster
![Workers' Compensation Poster](https://laborcommission.utah.gov/wp-content/uploads/2019/11/poster-english.jpg)
Form 350 – Emergency Medical Service Provider Exposure Report Form
![Form 350 - Emergency Medical Service Provider Exposure Report Form](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-350-Fillable.jpg)
Form 302 – Medical Records – Copies
![Form 302 - Medical Records - Copies](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-302-Fillable.jpg)
Form 223 – Authorization Request for Medical Procedures/Carrier Response
![Form 223 - Authorization Request for Medical Procedures/Carrier Response](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-223-Fillable.jpg)
Form 221c – Lower Extremity Restorative Services Authorization/Denial
![Form 221c - Lower Extremity Restorative Services Authorization/Denial](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-221c-Fillable.jpg)
Form 221b – Upper Extremity Restorative Services Authorization/Denial
![Form 221b - Upper Extremity Restorative Services Authorization/Denial](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-221b-Fillable.jpg)
Form 221a – Spine Injury Restorative Services Authorization/Denial
![Form 221a - Spine Injury Restorative Services Authorization/Denial](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-221a-Fillable.jpg)
Form 219 – Permanent Partial Disability Statement of Compensation
![Form 219 - Permanent Partial Disability Statement of Compensation](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-219-Fillable.jpg)
Form 123 – Physician’s Initial Report of Work Injury or Occupational Disease
![Form 123 - Physician's Initial Report of Work Injury or Occupational Disease](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-123-Fillable.jpg)
Form 102 – Application to Change Doctors
![Form 102 - Application to Change Doctors](https://laborcommission.utah.gov/wp-content/uploads/2019/11/Form-102-Fillable.jpg)