Get Form 308 3/12/15 State Of Utah Labor Commission Division ... - Laborcommission Utah

Filling out the Form 308 is essential for requesting the disclosure of protected health information pertinent to a workers' compensation claim. This guide will provide clear, step-by-step instructions to ensure that users can confidently complete the form.

Follow the steps to fill out the Form 308 correctly online.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. In the 'Requesting Party' section, clearly enter your name and contact telephone number.
3. Provide your complete address in the designated area to ensure proper identification.
4. Identify the medical provider by entering their name and contact details as required on Form 307.
5. In the 'Name of Patient' field, input the full name of the individual whose medical records are being requested.
6. Fill in the 'Social Security Number' and 'Date of Birth' fields accurately to confirm the identity of the patient.
7. Document all relevant 'Date(s) of Injury/Occupational Disease' to link medical records with the claim.
8. Read and understand the authorization statement, then check the appropriate boxes if applicable.
9. Sign and date the form at the bottom, ensuring that the signature is legible.
10. Find a notary public to witness your signature and complete the notary section.
11. Once completed, you can save the changes, download the document, print it, or share it as necessary.

Complete your documentation efficiently by filing the Form 308 online today!