Serving patients across all of Utah

Welcome to the Modivcare Facility web site for Utah Department of Health. Currently this site hosts information and forms that medical facilities and medical groups can use to schedule transportation for our clients.

The forms on this site are stored in PDF format. Your computer must have Adobe Acrobat Reader installed for you to be able to read and print the forms. If you do not have a copy of Adobe Acrobat, you can download it for free at

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Please click on the title that corresponds to the document you would like to view.

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