Forms & Documents

Browse all Department of Public Health forms

1 - 20 of 534 documents

Form Title Tags
2018-2019 Nursing Education Scholarship Program Application Newborn Screening Records
Adopted Person Registration Identification Form Adoption Registry
Adoption Registry Denial of Information Exchange Adoption Registry
Adoption Registry Information Exchange Authorization Form Adoption Registry
Adoption Registry Medical Information Exchange Questionnaire Form Adoption Registry
Adoptive Parent Registration Identification Form Adoption Registry
Adult Surrendered Person Registration Identification Form Adoption Registry
Affidavit and Certificate of Correction Request Death Records
Affidavit and Certificate of Correction Request Out-Patient Physical Therapy/Speech Pathology
Affidavit by Biological Father Legitimation
Affidavit by Biological Mother Legitimation
Aircraft Inspection Form - Provider EMS Provider and Vehicle Licensing, EMS Provider and Vehicle Licensing
Ambulatory Surgical Treatment Center License Application Ambulatory Surgical Treatment Centers
Ambulatory Surgical Treatment Center License Renewal Application Ambulatory Surgical Treatment Centers
Ambulatory Surgical Treatment Center Medicare Certification Ambulatory Surgical Treatment Centers
Annual and Monthly Poverty Level Guidelines Ryan White Care And Hopwa Services, Ryan White CARE And HOPWA Services
Annual Report Form for Public Health Dental Hygienist Oral Health
Appendix A: Exempt Determination Request Institutional Review Board
Appendix B: Research Involving Human Blood, Urine or Tissue Collection for Analytical Testing and/or Storage Institutional Review Board
Appendix C: Waiver of Consent Institutional Review Board

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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