Patient Forms 

Physician Forms

Release of Medical Information

University of Utah Health follows the Federal requirements for protection of your personal medical information. If you would like U of U Health to share (or receive) your medical health information with anyone (spouse, family member, other health care provider, etc.) you must give written permission. Please use the Patient Authorization Disclosure or Receipt of Protected Health Information form to give permission. Please read and complete the entire form.

Please note: Your signature must be witnessed by a U of U Health employee or a notary public.