Records Release Developmental Behavioral Health Clinic

You may request a copy of your records or request a transfer of your records by completing and signing a Records Request form. An electronic copy of the form is available by clicking the button below. The completed form can be faxed or mailed. A secure email is not available. Call 435-797-2002 with questions.

Phone: 435-797-2002
Fax: (844) 308-5865

Personal Record Request Form

Outside Record Request Form

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