Forms and Downloads
Save time! Complete the registration form at your leisure, then bring it on your next visit!
Please bring the following:
- Your registration form filled out.
- Your insurance card (if you have insurance).
- A paycheck stub if you are self-pay or want to take advantage of our sliding fee discounts (based on family size and income).
- For Intermountain lab vouchers, they require income verification and utility bills (as proof of Utah residency) for their voucher program.
Print out this form if you want to give pre-authorization so that medical care can be delivered directly to minors if a parent or legal decision maker cannot be present prior to treatment