Utah Forms
3 State Forms found
| name | number | revision | print or send online | |
|---|---|---|---|---|
EMPLOYER’S FIRST REPORT OF INJURY OR ILLNESS |
Form 122E | Revised 7/2024 | ||
Physician’s Initial Report of Work Injury or Occupational Disease |
Form 123 | Rev 7/2024 | ||
FIRST REPORT OF INJURY OR ILLNESS TO BE COMPLETED BY INSURANCE CARRIER OR SELF-INSURED EMPLOYER |
Form 122C | Rev 7/2024 | ||
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