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Probation and Compliance

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Forms

Probationers should check their Stipulation, Order or MOU to see which forms are required for their circumstances.

  • Publicly Available 12-Step & P.I.R. Programs
  • 12-Step/P.I.R. Log
  • Aftercare Report
  • Chaperone Log
  • Criminal Probation Report
  • Employer/Supervisor Report - General
  • Employer/Supervisor Report - Healthcare
  • Pharmacy Supervisor Report - Pharmacy
  • Health Care Provider Report
  • Licensee Certification of Receipt of MOU/Stipulation
  • Practice Plan Guidelines
  • Supervisor Report
  • Self Assessment Report
  • Therapy Report
  • Pharmacy Receipt of Stipulation/MOU
  • GRAMA Request Form

Useful Information from Others

  • Talbott Recovery Campus - Medication Guide for a Safe Recovery
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  • HOME
  • LICENSING
    • Licenses
    • Verify a License
    • Criminal History Guidelines
    • Military Resources
    • Licensing and Miscellaneous Fees
  • ENFORCEMENT
    • Investigations
    • Probation and Compliance
    • Disciplinary Actions and Citations
    • Disciplinary Newsletters
  • PROGRAMS
    • Controlled Substance Advisory Committee
    • Controlled Substance Database
    • Prelitigation
    • Construction Business Registry
    • Residence Lien Recovery Fund
    • Uniform Building Codes
    • Utah Professionals Health Program
    • State Construction Registry
  • LEARN MORE
    • Announcements
    • Fingerprints
  • ABOUT
    • Active Licensee Count
    • Proposed Rule Changes
    • GRAMA Records Request From
  • Search
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