Utah Billing & Recovery Services

First Name

Last Name

Address

City, State, Zip

phone number

email address

User Agreement

By providing my phone number and/or my email address, I hereby consent to being contacted at that phone number and/or email address on all matters relating to this account. I verify that the above phone number and/or email address is a valid way to contact me. I understand that I am responsible for all charges assessed by my telephone provider.

In order to help verify your identity

Last 4 of social security

Your account # with our office

User Agreement

By continuing, you agree to our Privacy Policy

Privacy Policy