787 W. Highway 40
Vernal, UT 84078
Phone:(435) 789-7533
Billing: (435) 790-7533

Registration Forms

You may access the following forms to assist us with your care. Please print and fill out the desired form, then bring it to your appointment.

*These forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, Click the Adobe logo to download.