Release of Medical Information
ÑÇÖÞ×ÔοÊÓƵ of Utah ÑÇÖÞ×ÔοÊÓƵ follows federal requirements to protect your personal medical information. If you would like U of U ÑÇÖÞ×ÔοÊÓƵ to share your medical health information with anyone (spouse, family member, other health care provider) you must give written permission.
To give permission, please use the Patient Authorization Disclosure or Receipt of Protected ÑÇÖÞ×ÔοÊÓƵ Information form. Please read and complete the whole form.
Please note: A U of U ÑÇÖÞ×ÔοÊÓƵ employee or a notary public must act as a witness when you sign the paperwork.
