Utah Medicaid Forms

The forms below are updated on a bimonthly basis when necessary. They have been alphabetized for your convenience. If you have questions, contact the webmaster or call Medicaid Information at (801) 538-6155 or 1-800-662-9651.

If you are a Medicaid member, you can access literature, forms, and other publications at the Utah Medical Benefits website; click here opens in a new tab.

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If you have comments or questions, need hard copies or archived official Medicaid materials, please email MedicaidOps@utah.gov.