Skip nav to main content.

Forms and Information

Medical Patient Forms:

Patient RegistrationNotice of Privacy Practices
Sliding Fee PolicyUtah Medicaid Application
Dental Patient Registration and Consent FormFourPoints Health Records Release
SDPI Program ApplicationFourPoints Code of Conduct Agreement
Document Upload

Behavioral Health Forms:

Behavioral Health Policies and ProceduresFourPoints Consent to Release Information
Prime for Life ScheduleRed Road to Sobriety-AA
Notice of Privacy Practices  Code of Conduct Agreement
Document Upload