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Forms
Referral Form
To request consultation or testing, fill our
and fax to:
801-281-5960.
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You can also use our secure online referral form.
Registration
Fill out the registration form prior to your visit to speed the check in process.
Medical Records
Send a signed copy of our Medical Release of Information to every facility where you have been treated.
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More information regarding medical records here.
Handicap Parking
Review and sign our service agreement to speed the check in process.
Privacy Statement
Review our Privacy Statement.
Handicap Parking
If you need a handicap parking permit, fill out the form and give it to us for medical signature.
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