Osteopathic Physician and Surgeon
Additional Forms
- Electronic Prescriptions for Controlled Substances: Request for Limited Extension to Comply
- Controlled Substance Application Form
- Designation of Contact Form
- Tax Credit Attestation: New Utah Practice
- Tax Credit Attestation: Underserved
- Tax Credit Attestation: Volunteer Retired Psychiatrist
- Application for Inactive Licensure
- Volunteer Health Care Practitioner
- Request to Remove Controlled Substance License
- Restricted Associate Osteopathic Physician Collaborative Practice Agreement
- Transgender Treatment Certification
