Cermak Health Services of Cook County

Cook County, IL

Official Website: https://cookcountyhealth.org/locations/cermak-health-services-of-cook-county/

Forms & Documents

Browse all Cermak Health Services of Cook County government forms

1 - 20 of 24 forms

Form Title Topics
ADULT  for Minor Informed Consent with HIPAA Authorization Form
ADULT Informed Consent with HIPPA Authorization Form
Arabic Certificate of Translation
Arabic Short Form Consent
Child Assent Document
Cook County Health HIPAA Authorization for Research
Cook County Health HIPAA Authorization for Research – Spanish
Creole Certificate of Translation
Creole Short Form Consent
English Short Form Consent
HIPAA Language Consent Form
Laboratory
Mandarin Certificate of Translation
Mandarin Short Form Consent
Pharmacy
Polish Certificate of Translation
Polish Short Form Consent
Reliance Agreement Request
Russian Certificate of Translation
Russian Short Form Consent

Contact Information & Office Locations

1 contact point

Main Office

Address:
2800 S. California Ave.
Chicago, IL 60608

Phone numbers:
  • (773) 674-7488

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