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Get UT DoH Initial Entity Report 2017-2024

Print Form UTAH DEPARTMENT OF HEALTH DIVISION OF FAMILY HEALTH AND PREPAREDNESS BUREAU OF HEALTH FACILITY LICENSING AND CERTIFICATION PO BOX 144103 SALT LAKE CITY, UT 84114-4103 (801) 273-2994 (800) 662-4157 toll free (801) 274-0658 Fax HealthFacilityComplaint utah.gov INITIAL ENTITY REPORT REPORTING INDIVIDUAL EMAIL ADDRESS PHONE NUMBER FACILITY NAME ADDRESS TYPE OF REPORT RESIDENT TO RESIDENT STAFF TO RESIDENT UNKNOWN INJURY MISAPPROPRIATION ELOPEMENT OTHER INDIVIDUAL(S) INVOLVED R.

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