Forms & Documents
Browse all Department of Public Health government forms
121 - 140 of 534 forms
| Form Title | Topics |
|---|---|
| Declaration for Mental Health Treatment Form (En Espanol | Advance Directives |
| Denial of Access to a Nursing Home | Nursing Homes |
| Dental Examination Waiver Form | Oral Health |
| Disclosure or Change of Ownership and Tax ID | Clinical Laboratory Improvement Amendments |
| Dispenser License: Initial Application Packet | Hearing Instrument Consumer Protection Program |
| Dispenser License: Modification Form Packet | Hearing Instrument Consumer Protection Program |
| Dispenser License: Renewal Application | Hearing Instrument Consumer Protection Program |
| Drowning/Injury/Illness/ Incident Report | Swimming Facilities |
| Electronic Monitoring Consent Form | Nursing Homes |
| Electronic Records Review Form | Structural Pest Control |
| EMS Alternate Rural Staffing Authorization Request | EMS Provider and Vehicle Licensing, EMS Provider and Vehicle Licensing |
| EMS Ambulance Inspection | EMS Provider and Vehicle Licensing, EMS Provider and Vehicle Licensing |
| EMS Ambulance Staffing Waiver Application | EMS Provider and Vehicle Licensing, EMS Provider and Vehicle Licensing |
| EMS Authorization Release Information | Ems Personnel And Ambulance Licensing And Inspection, EMS Personnel And Ambulance Licensing And Inspection |
| EMS Authorization Release Information | EMS Licensing, EMS Licensing |
| EMS Duplicate License Request | EMS Licensing, EMS Licensing |
| EMS Equipment Waiver | EMS Provider and Vehicle Licensing, EMS Provider and Vehicle Licensing |
| EMS Examination Application | Ems Personnel And Ambulance Licensing And Inspection, EMS Personnel And Ambulance Licensing And Inspection |
| EMS Extension Request Application | EMS Licensing, EMS Licensing |
| EMS Inactive Request | EMS Licensing, EMS Licensing |
Contact Information & Office Locations
All 3 contact points
Chicago Headquarters Offices
IDPH
Address:
122 S. Michigan Avenue
7th and 20th Floors
Chicago, IL 60603
- (312) 814-2793
Chicago Headquarters Offices
IDPH
Address:
69 W. Washington Street
35th Floor
Chicago, IL 60602
- (312) 814-5278
Springfield Headquarters Office
IDPH
Address:
525-535 West Jefferson Street
Springfield, IL 62761
- (217) 782-4977