Forms
Human services licensing
Required and sample forms can be found on this page.
Any personal data requested is collected in accordance with the DLBC privacy notice.
Human services program forms
Checklists have been moved to the rules and license types webpage.
Client rights poster (English)
Client rights poster (Spanish)
Utah abuse and neglect reporting law (English)
Utah abuse and neglect reporting law (Spanish)
Americans with disabilities act notice (English)
Americans with disabilities act notice (Spanish)
Civil rights notice (English)
Civil rights notice (Spanish)
Provider code of conduct (English)
Provider code of conduct (Spanish)
Administrative hearing request
Code of conduct and client rights
Foster care rule
Foster/proctor care - Initial family application for agencies
Foster/proctor care - Renewal application for agencies
Foster/proctor care - Home study update template for agencies
Foster/proctor care - Initial home study template for agencies
General provisions rule guide(Currently unavailable)
HCBS settings rule attestation tool and provider self-assessment tool for residential settings
HCBS settings rule attestation tool and provider self-assessment tool for non-residential settings
ICPC 100A form
ICPC 100B form
TB screening tool
Youth education coordinating form