PRIVACY NOTICE (NON-PUBLIC RECORDS)
NOTICE FOR NON-PUBLIC PERSONAL DATA COLLECTION
The Southwest Utah Public Health Department (SWUPHD) is a governmental entity subject to Utah Code 63A-19-402.
Personal information collected by SWUPHD is used solely to provide public health services to residents and clients.
Should you wish not to provide any personally identifiable information through our website, you may utilize our services by using the appropriate non-electronic means, or you may decline to pursue the services, since we cannot serve you without the minimal personal information.
Personal data is only shared or stored with state and federal public health agencies or other official partners as required by law to deliver services. We do not sell personal information.
To access, review, or correct your personal data, please contact info@swuhealth.gov.
You may also review our main Privacy Policy at swuhealth.gov/privacy.
Last reviewed: 7/13/2026
Privacy Statements by Document
Select a division below to view the privacy statements for specific forms and applications.
Clinical Services
Baby Your Baby (BYB) Application
Why We Collect Your Data and How We Use It
We collect your personal, financial, and medical information (including your name, contact information, Social Security number, citizenship status, household income, pregnancy status, and household size) to evaluate your preliminary eligibility for temporary Medicaid coverage under the Baby Your Baby (BYB) / Prenatal (PEPI) program. We use this information to process your application, provide prenatal care coordination, conduct nursing visits, and forward your application to the Department of Workforce Services (DWS) to determine your eligibility for continued medical benefits. Social Security numbers and citizenship statuses are strictly collected because they are legally mandated by state and federal law to verify identity and Medicaid eligibility.
Consequences of Refusing to Provide Information
Providing this personal data is required to determine your eligibility for benefits. If you choose not to provide the requested information, we will be unable to assess your application, which may result in you being denied temporary Medicaid coverage and associated prenatal care coordination services.
Record Series and Privacy Classification
The personal data you furnish will be filed under our official Record Series for Patient and Client Case Files (State Schedule GRS-1706). Under the Government Records Access and Management Act (GRAMA), the information collected on this application is classified as a Private or Controlled record. Private records are legally available to the subject of the record, the parent or legal guardian of a minor subject, a legal guardian of an incapacitated adult, or someone with a notarized release or power of attorney. Because this form collects sensitive medical history and pregnancy status, portions of this record may be classified as Controlled. Controlled records are restricted from the subject and are only released to qualified medical or health professionals upon submission of a release, specifically if releasing the medical information directly to the subject would be detrimental to their mental health or safety, or violate medical ethics. It will be retained for 7 years after your case is closed, or for 22 years after the date of birth (whichever is greater), before being securely destroyed.
Who We Share Your Data With
To fulfill your request and comply with legal requirements, the personal data you provide on this application is shared directly with the Department of Workforce Services (DWS), the Utah Department of Health and Human Services (DHHS), and authorized Tribal organizations as required to coordinate care and benefits. We do not use commercial third-party contractors to process this data; we do not sell your personal data to any third parties, and it is not shared with any commercial entities.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you or your legal guardian may request an amendment or correction of the personal data you have furnished on this application by contacting the SWUPHD Records Officer. Please note: Requests to amend or correct this data will only apply to the local prenatal case files held by the Southwest Utah Public Health Department and cannot be used to legally amend official Medicaid enrollment or financial records held by the Department of Workforce Services (DWS).
Clinical Services & Immunization Forms
Why We Collect Your Data and How We Use It
We collect your personal identifying information, demographics, insurance details, and sensitive medical history (including prior illnesses, allergies, and pregnancy status) to assess your health risks, safely administer vaccines and prophylactic medications, provide accurate health and travel consultations, process medical billing, and legally secure written consent for treatment. For supplemental forms, this information is used to legally authorize the release of your medical records or to process your requests to amend your health information.
Consequences of Refusing to Provide Information
Providing this personal data is voluntary; however, if you choose not to provide the requested information, our clinical staff will be unable to safely assess your health risks, determine vaccine contraindications, administer requested vaccines or medications, process your insurance billing, or fulfill your medical record release and amendment requests.
Record Series and Privacy Classification
The personal data you furnish will be filed under our official Record Series 16686: Immunization records – Tracking cards. Under the Government Records Access and Management Act (GRAMA), the information collected on these forms is classified as a Private or Controlled record. Private records are legally available to the subject of the record, the parent or legal guardian of a minor subject, a legal guardian of an incapacitated adult, or someone with a notarized release or power of attorney. Because this form collects sensitive medical history, portions of this record may be classified as Controlled. Controlled records are restricted from the subject and are only released to qualified medical or health professionals upon submission of a release, specifically if releasing the medical information directly to the subject would be detrimental to their mental health or safety, or violate medical ethics. It will be retained for 10 years after your last visit or until the client has reached the age of 21 before being securely destroyed.
Who We Share Your Data With
To provide your care and fulfill public health operations, the personal data you provide is shared directly with the Utah Statewide Immunization Information System (USIIS), your health insurance provider, and consulting medical professionals (such as the University of Utah for travel medicine). We also share your personal data with Connexin Software, Inc., which maintains our Electronic Health Record (EHR) system (Office Practicum), and with our merchant gateway provider solely for the purpose of processing financial payments. These commercial third-party vendors are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department. We do not sell your personal data to any third parties, and it is not shared with any other commercial or governmental entities.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you or your legal guardian may request an amendment or correction of the personal data you have furnished on these forms by contacting the Southwest Utah Public Health’s Clinical Services division. Please note: Requests to amend or correct this data will only apply to the local medical and billing files held by the Southwest Utah Public Health Department and cannot be used to legally amend official state records held within the Utah Statewide Immunization Information System (USIIS) or your private health insurance records.
Vaccination Exemption Form
Why We Collect Your Data and How We Use It
We collect your personal identifying information and your child’s medical data (including parent/guardian name, child’s name, date of birth, and specified exemption reasons—personal, medical, or religious) to legally document your child’s exemption from required immunizations. We only use this information to verify the completion of the state-mandated online vaccination education module and to fulfill official public health and educational enrollment requirements under Utah law.
Consequences of Refusing to Provide Information
Providing this personal data is required to obtain a valid vaccination exemption. If you choose not to provide the requested information, we will be unable to legally issue the exemption certificate, which may result in your child being denied enrollment or attendance at a school or child care facility unless they receive the state-mandated vaccines.
Record Series and Privacy Classification
The personal data you furnish will be filed under our official Record Series 16846: Immunization personal exemption record. Under the Government Records Access and Management Act (GRAMA), the information collected on this form is classified as a Private record. Private records are legally available to the subject of the record, the parent or legal guardian of a minor subject, a legal guardian of an incapacitated adult, or someone with a notarized release or power of attorney. It will be retained for 21 years after the child’s date of birth before being securely destroyed.
Who We Share Your Data With
To fulfill your request and comply with legal requirements, we share your personal data with Connexin Software, Inc., which maintains our Electronic Health Record (EHR) system (Office Practicum), who are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department. We do not share this data with the Utah Statewide Immunization Information System (USIIS), the Utah Department of Health and Human Services (State Health Department), or the specific school or child care facility where your child is enrolled. We do not use any other commercial third-party contractors to process this data; we do not sell your personal data to any third parties, and it is not shared with any other commercial or governmental entities.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you or your legal guardian may request an amendment or correction of the personal data you have furnished on this form by contacting the Southwest Utah Public Health Department’s Clinical Services division. Please note: Requests to amend or correct this data will only apply to the local exemption records held by the Southwest Utah Public Health Department and cannot be used to legally amend records you have already physically submitted to a school or child care facility.
Vital Records
Burial Transit Permits
Why We Collect Your Data and How We Use It
We collect the decedent’s identifying information (including full name, sex, age, birth date, birthplace, and date/county of death)—though the name is not strictly required for fetal remains under 20 weeks gestational age. We also collect the name, relationship, and mailing address of the authorizing person or facility, alongside the funeral director or dispositioner’s details and the intended method and location of final disposition (such as a specific cemetery or crematory). Additionally, we collect payment details for your transaction, and, as mandated by the Utah Vital Records office, we are required to collect and retain a copy of any out-of-state identification, passports, visas, or other government-issued identification. We use this information exclusively to legally authorize and document the transportation, out-of-state transit, cremation, or final disposition of human or fetal remains. We also use this data to ensure compliance with state law by verifying that satisfactory proof of a death certificate or fetal death certificate has been filed before the permit is issued. Please note that payment details are collected solely for immediate processing and are not retained by the Vital Records Department.
Consequences of Refusing to Provide Information
Providing this data is legally required to authorize the movement and final disposition of human or fetal remains, particularly when remains are being transported out of Utah or when disposition is made by someone other than a licensed funeral director. If you choose not to provide the requested information, the local or state registrar cannot issue the Burial Transit Permit. Without this legal permit, a sexton or cemetery manager cannot allow the interment of the remains, and the body or fetus cannot be legally transported out of state, cremated, or otherwise reach final disposition.
Record Series and Privacy Classification
The data you furnish on the application will be filed under our official vital Records Series: 13679 Death Hold Book, mapped to the state’s General Retention Schedule GRS-285: Vital records. Under the Government Records Access and Management Act (GRAMA), permits acting as official legal documentation of the final disposition of remains may be classified as Public records. Any underlying personal data is classified as a Private record (available to the surviving spouse, next of kin, the legally appointed personal representative of the estate, or as otherwise designated by Utah Code), while underlying medical, psychiatric, or psychological data is classified as a Controlled record (subject to strict access restrictions and generally only available to medical professionals or public health agencies). As instructed by the Utah Vital Records office, these applications and identification copies are kept for 1 year after the end of the calendar year and then destroyed. Payment receipts are transferred to our accounting department and filed under GRS-106 (Local government accounts payable and receivable records), where they are retained for 4 years to fulfill government financial obligations.
Who We Share Your Data With
To fulfill legal requirements for the movement and disposition of human remains, the data provided on this permit is shared directly with the Utah Department of Health and Human Services (State Office of Vital Records and Statistics), local health department registrars, the funeral director or authorized dispositioner handling the remains, and the sextons or managers of the receiving cemeteries or crematories. To process your request, the information you provide is verified against the State of Utah’s Integrated Registration Information System (IRIS) to generate the physical permit document you receive upon completion; your application data is not entered into the IRIS database by our department. We do not sell your personal data to any third parties. Additionally, we share personal data with third-party payment processing companies that handle your transaction, who are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you may request an amendment or correction to the personal data you have submitted on this application by contacting the Southwest Utah Public Health Department’s Vital Records division. Please note: Personal data collected with this paperwork is only used to process this request. Requests to amend or correct this data will only be used to correct application data held by the Southwest Utah Public Health Department and cannot be used to amend a certificate, permit, or other official vital record.
Death Certificate Application
Why We Collect Your Data and How We Use It
We collect your personal identifying information (including your name, contact information, and photocopies of acceptable identification), the specific vital record details needed to locate a death record, and payment details. We use this information exclusively to verify your identity, establish your legal relationship to the certificate holder, process associated fees, and fulfill your request for a certified copy or issue a Certificate of Search if the record cannot be located or you are not legally entitled to it. Please note that payment details are collected solely for immediate processing and are not retained in your vital records application file. As mandated by the Utah State Office of Vital Records and Statistics, we are required to collect and retain a copy of out-of-state identification, passports, visas, or other government-issued identification.
Consequences of Refusing to Provide Information
Providing this personal data and proof of identity is legally required to access non-public vital records. If you choose not to provide the requested information, missing application details, or acceptable identification, we will be unable to verify your identity or legal entitlement, which will result in your application being denied and returned.
Record Series and Privacy Classification
The personal data you furnish on the application will be filed under our official Record Series 13678: Death certificate applications. Under the Government Records Access and Management Act (GRAMA), the information collected on these forms is classified as a Private record and is available to the surviving spouse, next of kin, the legally appointed personal representative of the estate, or as otherwise designated by Utah Code. If supplementary documentation provided to prove your legal relationship contains medical or psychological data, that specific data will be classified as a Controlled record under GRAMA. Unlike Private records, access to Controlled medical data is strictly limited to authorized licensed healthcare professionals or as otherwise explicitly defined by Utah Code § 63G-2-202. It will be retained for 1 year after the end of the calendar year in which the administrative need ends before being securely destroyed. Payment receipts are transferred to our accounting department and filed under GRS-106 (Local government accounts payable and receivable records), where they are retained for 4 years to fulfill government financial obligations.
Who We Share Your Data With
To fulfill your request and comply with legal requirements, the personal data you provide on these forms is shared directly with the Utah Department of Health and Human Services (State Office of Vital Records and Statistics) to verify the record and issue the certificate. We do not sell your personal data to any third parties. Additionally, we share personal data with the following classes of entities to facilitate our official processing duties: third-party payment processing companies that handle your transaction, and contracted IT vendors hosting our application databases, who are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you may request an amendment or correction to the personal contact or payment data you have submitted on this application by contacting the Southwest Utah Public Health Department Vital Records Division. Please note: This procedure applies only to the application data held by the Southwest Utah Public Health Department. It cannot be used to amend or correct the official death certificate itself. To request an amendment to an official vital record, you must follow the legal amendment procedures established by the Utah State Office of Vital Records and Statistics.
Disinterment/Reinterment Permit
Why We Collect Your Data and How We Use It
We collect the decedent’s identifying information (name, sex, date of birth, place of death) and current and future cemetery locations, along with the personal identifying information, relationships, and signatures of the next of kin, new grave owner, and funeral director or authorized agent. We also collect payment details for your transaction. We use this information exclusively to legally authorize and document the disinterment, cremation, reinterment, out-of-state transit, or autopsy of human remains, and to verify that a majority of the next of kin have formally consented to the action. Please note that payment details are collected solely for immediate processing and are not retained in the permanent permit file.
Consequences of Refusing to Provide Information
Providing this data and the required signatures is legally required to authorize the movement of human remains. If you choose not to provide the requested information or fail to secure the signatures of a majority of the next of kin, the local or state registrar cannot issue the permit. As a result, the remains cannot be legally disinterred, relocated, or otherwise altered.
Record Series and Privacy Classification
The data you furnish on the application will be filed under our official Record Series 13682: Disinterment permit. Under the Government Records Access and Management Act (GRAMA), the final authorized permit documenting the movement of remains is classified as a Public record. However, to protect your privacy, the underlying personal contact information and signatures of the next of kin are classified as a Private record and are available only to the individuals who submitted the data, their legally authorized representatives, or as otherwise designated by Utah Code. Because these permits act as official legal documentation of the final disposition and movement of remains, they are legally required to be retained permanently and may be transferred to the State Archives. We maintain the official record copy of this permit before the physical document is given to the client. Payment receipts are transferred to our accounting department and filed under GRS-106 (Local government accounts payable and receivable records), where they are retained for 4 years to fulfill government financial obligations.
Who We Share Your Data With
To fulfill legal requirements for the movement of human remains, the data provided on this application is shared directly with the Utah Department of Health and Human Services (State Office of Vital Records and Statistics), local health department registrars, the funeral director or authorized agent handling the disposition, and the sextons or managers of the present and future cemeteries. To process your request, the information you provide may be verified against the State of Utah’s Integrated Registration Information System (IRIS) to generate the physical permit; your application data is not entered into the IRIS database by our department. We do not sell your personal data to any third parties. We share personal data with third-party payment processing companies to handle your transaction, who are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department. We do not use commercial IT vendors to host this data, and it is not shared with any other commercial entities.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you may request an amendment or correction to the personal contact or payment data you have submitted on this application by contacting the Southwest Utah Public Health Department’s Vital Records division. Please note: Personal data collected with this paperwork is only used to process this request. Requests to amend or correct this data will only be used to correct data held by the Southwest Utah Public Health Department and cannot be used to legally amend a certificate, permit, or other official vital record.
Dispositioner Packet (Death Registration)
Why We Collect Your Data and How We Use It
We collect the decedent’s comprehensive demographic, familial, and medical data (including their Social Security number, education level, occupation, parents’ names, and place/cause of death) as well as your personal identifying and contact information as the dispositioner or informant. We use this information exclusively to legally register the death, create the official permanent death record and certificate, follow up with you if additional information is needed, and legally authorize the final disposition (burial, cremation, or transit) of the remains. The decedent’s Social Security number is strictly collected because it is mandated by state and federal law for vital statistics and Social Security Administration reporting.
Consequences of Refusing to Provide Information
Providing this data is legally required to register a death in the State of Utah. All fields on the worksheet are required unless explicitly marked as optional; if you choose not to provide the requested information, we will be unable to legally register the death record. This failure will result in a delay of the official death record and may prevent or delay the final disposition or burial of the remains. (Note: Intentionally providing false information on this form to fraudulently register a death is a Class B misdemeanor and can result in civil penalties of up to $5,000 and imprisonment.)
Record Series and Privacy Classification
The demographic and personal data you furnish will initially be filed under the state-assigned Record Series 81448: Decedent Demographic Data. Because this information legally becomes part of the official death certificate, it is tied to our permanent vital records (such as Record Series 13676 or 29748: Death certificates), which are legally required to be retained permanently for 50 years. Under the Government Records Access and Management Act (GRAMA) and Utah Code 26B-8-125, the decedent’s medical data and cause of death are classified as Controlled records. The dispositioner’s personal contact information and the decedent’s demographic data are classified as Private records. It is restricted from the general public and only accessible to individuals with a direct, tangible, and legitimate legal interest.
Who We Share Your Data With
To fulfill legal death registration requirements, the data provided on this form is shared directly with the funeral home handling the disposition, the certifying physician, the Office of the Medical Examiner (if applicable), and the Utah Department of Health and Human Services (State Office of Vital Records and Statistics). To process this registration, the information is entered directly into the State of Utah’s official electronic vital records systems (such as EDEN/IRIS), which are maintained by the State and its approved technical contractors. We do not sell your personal data to any third parties. We share personal data with the funeral home handling the disposition to facilitate our official processing duties. Any technical contractors interacting with this data are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing specified services to the State or Department. We do not share your data with any other commercial entities.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you may request an amendment or correction to the personal contact data you have submitted on this application by contacting the Southwest Utah Public Health’s Vital Records division. Please note: Requests to amend or correct this data will only be used to correct application data held by the Southwest Utah Public Health Department and cannot be used to legally amend an official death certificate or vital record.
Marriage/Divorce Certificate Application
Why We Collect Your Data and How We Use It
We collect the spouses’ identifying information (names and the place and date of the marriage or divorce) as well as your personal identifying information (including your name, contact information, relationship to the certificate holders, and photocopies of acceptable identification) and payment details. We use this information exclusively to verify your identity, establish your legal entitlement and relationship to access a restricted vital record, process associated fees, and fulfill your request for a certified copy of a marriage or divorce certificate. Please note that payment details are collected solely for immediate processing and are not retained with the application.
Consequences of Refusing to Provide Information
Providing this personal data and proof of identity is legally required to access non-public vital records. If you choose not to provide the requested information, acceptable identification, or proof of relationship/legal need, we will be unable to verify your identity or legal entitlement. This will result in your application being denied and returned to you. If required information is missing from the application, you will have 90 days to provide it before you must repay the fees.
Record Series and Privacy Classification
The personal data you furnish on the application will be filed under Record Series 13675 to accommodate the Utah Office of Vital Records mandate to destroy the application after 1 year. Under the Government Records Access and Management Act (GRAMA), the information collected on these applications is classified as a Private record. Private records are restricted from the general public and are legally available only to the subject of the record, the parent or guardian of a minor subject, a legal guardian of an incapacitated adult, or someone with a notarized release or power of attorney. Payment receipts are transferred to our accounting department and filed under GRS-106 (Local government accounts payable and receivable records), where they are retained for 4 years to fulfill government financial obligations.
Who We Share Your Data With
To fulfill your request and comply with legal requirements, the personal data you provide on these forms is shared directly with the Utah Department of Health and Human Services (Office of Vital Records and Statistics) to verify the record and issue the certificate. To process your request, the information you provide is verified against the State of Utah’s electronic vital records database; your application data is not entered into the state database by our department. We do not sell your personal data to any third parties. We share personal data with third-party payment processing companies to handle your transaction, who are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department. We do not share your data with any other commercial entities.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you may request an amendment or correction to the personal contact or payment data you have submitted on this application by contacting the Southwest Utah Public Health Department’s Vital Records division. Please note: Personal data collected with this paperwork is only used to process this request. Requests to amend or correct this data will only be used to correct application data held by the Southwest Utah Public Health Department and cannot be used to legally amend a marriage, divorce, or other official vital record.
Stillbirth Certificate Application
Why We Collect Your Data and How We Use It
We collect your personal identifying information (including your name, contact information, and photocopies of acceptable identification), the specific vital record details needed to locate a stillbirth or fetal death record, and payment details. We use this information exclusively to verify your identity, establish your legal relationship to the subject of the certificate, process associated fees, and fulfill your request for a certified copy or issue a Certificate of Search if the record cannot be located or you are not legally entitled to it. Please note that payment details are collected solely for immediate processing and are not retained in your vital records application file. As mandated by the Utah State Office of Vital Records and Statistics, we are required to collect and retain a copy of out-of-state identification, passports, visas, or other government-issued identification.
Consequences of Refusing to Provide Information
Providing this personal data and proof of identity is legally required to access non-public vital records. If you choose not to provide the requested information, missing application details, or acceptable identification, we will be unable to verify your identity or legal entitlement, which will result in your application being denied and returned.
Record Series and Privacy Classification
The personal data you furnish will be filed under the state’s General Retention Schedule GRS-1720: Transitory tracking records. Under the Government Records Access and Management Act (GRAMA), the information collected on these forms is classified as a Private record and is available to the parents listed on the record, the surviving spouse, next of kin, the legally appointed personal representative of the estate, or as otherwise designated by Utah Code. If supplementary documentation provided to prove your legal relationship contains medical or psychological data, that specific data will be classified as a Controlled record under GRAMA. Unlike Private records, access to Controlled medical data is strictly limited to authorized licensed healthcare professionals or as otherwise explicitly defined by Utah Code § 63G-2-202. It will be retained for 1 year after the end of the calendar year in which the administrative need ends before being securely destroyed. Payment receipts are transferred to our accounting department and filed under GRS-106 (Local government accounts payable and receivable records), where they are retained for 4 years to fulfill government financial obligations.
Who We Share Your Data With
To fulfill your request and comply with legal requirements, the personal data you provide on these forms is shared directly with the Utah Department of Health and Human Services (State Office of Vital Records and Statistics) to verify the record and issue the certificate. We do not sell your personal data to any third parties. Additionally, we share personal data with the following classes of entities to facilitate our official processing duties: third-party payment processing companies that handle your transaction, and contracted IT vendors hosting our application databases, who are contractually prohibited from retaining, using, or disclosing this data for any purpose other than providing these specified services to the Department.
Procedure to Correct Personal Data
In accordance with the Government Data Privacy Act, you may request an amendment or correction to the personal contact or payment data you have submitted on this application by contacting the Southwest Utah Public Health Department Vital Records Division. Please note: This procedure applies only to the application data held by the Southwest Utah Public Health Department. It cannot be used to amend or correct the official stillbirth certificate itself. To request an amendment to an official vital record, you must follow the legal amendment procedures established by the Utah State Office of Vital Records and Statistics.