Department of Public Health

Official Website: http://dph.illinois.gov

Forms & Documents

Browse all Department of Public Health government forms

261 - 280 of 534 forms

Form Title Topics
Identified Offender Program FEAPP Consent Form Identified Offenders
IDPH Arbovirus Lab Submission Form Complaints
IDPH Board Member Form and Application About IDPH, About IDPH
IDPH Consent to Release Medical or Confidential Records Form Freedom Of Information Act
IDPH Freedom of Information Act Request Form Freedom Of Information Act
IDPH Test Request For Human Arbovirus Panel Form Clinical Testing
Illinois Adoption Registry and Medical Information Exchange (IARMIE) Application Adoption Registry
Illinois Certificate of Adoption Adoption
Illinois Department of Public Health Notice of Involuntary Transfer or Discharge and Opportunity for Hearing for Nursing Home Identified Offenders
Illinois State Loan Repayment Program Provider Application National Health Service Corps State Loan Repayment Program
Illinois State Loan Repayment Program Site Application National Health Service Corps State Loan Repayment Program
Illinois State Police Background Check Guide Identified Offenders
Individual Agreement I-CARE (Immunization Records), I-CARE (Immunization Records)
Influenza-Associated Pediatric Mortality Case Report Form National Health Service Corps State Loan Repayment Program
Influenza Guidance - Long Term Care Facilities Clinical Testing
Influenza Laboratory Test Requisition Clinical Testing
Influenza Testing and Reporting Memo Clinical Testing
Injury and Illness Report Campgrounds And Youth Camps
Installation Report for Water Well Pumps Private Water And Closed Loop Wells
Instructions - Addition of Services Home Health Agencies

Contact Information & Office Locations

All 3 contact points

Chicago Headquarters Offices

IDPH

Address:
122 S. Michigan Avenue
7th and 20th Floors
Chicago, IL 60603

Phone numbers:
  • (312) 814-2793

Chicago Headquarters Offices

IDPH

Address:
69 W. Washington Street
35th Floor
Chicago, IL 60602

Phone numbers:
  • (312) 814-5278

Springfield Headquarters Office

IDPH

Address:
525-535 West Jefferson Street
Springfield, IL 62761

Phone numbers:
  • (217) 782-4977

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