Office of Health Care Statistics Request for Extension or Exemption Form

Office of Health Care Statistics Request for Extension or Exemption Form


Per Utah Administrative Rule 428-2-10, the Office may grant exemptions or extensions from reporting requirements in Title R428 to data suppliers under certain circumstances.

Exemption: may be granted if a data supplier demonstrates that compliance imposes an unreasonable cost. Maximum, one year.

Extension: may be granted when the supplier demonstrates that technical or unforeseen difficulties prevent compliance. Maximum, 30 days.

For either case, please complete the form below and submit to our office for review and processing. We should have a decision to you within a few business days.

If you need to extend an existing, approved request, we must receive a new request in our office at least seven calendar days before the deadline.