Print Document

When you click Print below we will prepare a printable document for you. It will automatically download when it's ready.

Did you know?
You can fill in the document online and then click the print icon and all of your information will be populated in the printable document, saving you time later.

SeamlessDocs

Upon Completion of this form, please print off and bring in person to Box Elder County the Right of Access Provider Waiver Form and physically bring in your driver's license to someone in BOX ELDER COUNTY HUMAN RESOURCES at the Box Elder County Courthouse. This form must be signed and inititialled in person in order to run the required background check

Please check that you agree before continuing.

By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored. I also acknowledge that I have read and understand what forms need to be submitted and signed in person.

03/30/2026Click to Sign

Signature HereClick to Sign

03/30/2026Click to Sign

Signature HereDiane Back Will Sign Here

03/30/2026

Fair

Signature HereClick to Sign

03/30/2026Click to Sign

Signature HereDiane Back Will Sign Here

03/30/2026

Additional Signatures Required

Sign Now!

Please provide accurate information below to ensure the delivery of the signed copies of the document.

Listed Signers

	Signer Details	Me?
Signer1
I'm not a signer listed above

Print Document

Create Your Signature

Sign Now!

Please provide accurate information below to ensure the delivery of the signed copies of the document.

Listed Signers

Other Signers (The signers below will be invited to sign once the above signers have signed.)

Diane Back