Illinois Department of Public Health Forms

This document provides an action plan for managing asthma in the state of Illinois. It outlines steps to be taken in case of asthma symptoms, including medication usage and emergency contacts. This plan helps individuals with asthma effectively control their condition.

This form is used for reporting and documenting the death of an individual in the state of Illinois.

This form is used for plumbing contractors in Illinois to apply for registration or renewal.

This Form is used for Illinois residents who are seeking to apply for gender reassignment.

This form is used for notifying nursing home residents in Illinois about their involuntary transfer or discharge and providing them with an opportunity for a hearing.

This form is used for proving dental examination in schools in Illinois.

This document certifies child support for plumbing services in Illinois.

This document is used in Illinois to express an individual's wishes regarding medical treatment if they become unable to make decisions for themselves.

This form is used for reporting the follow-up results of hearing screenings as part of the Early Hearing Detection and Intervention program in Illinois.

This Form is used for obtaining a surety bond for partnership irrigation contractors who install lawn sprinkler systems in the state of Illinois.

This document is a request for seals and certificates needed for the installation of a manufactured home in the state of Illinois.

This document provides guidelines and procedures for organizing and conducting health screening events in the state of Illinois. It covers various aspects such as event planning, participant eligibility, screening methods, and reporting requirements.

This Form is used for declaring treatment for mental health in Illinois.

This form is used for denying the exchange of information in the state of Illinois.

This Form is used for requesting and evaluating Grade A milk laboratory evaluations in Illinois.

This Form is used for the Illinois Uniform Practitioner Order for Life-Sustaining Treatment (POLST) Form.

This type of document is used for enrolling healthcare providers in the state of Illinois.

This document is used in Illinois for declaring the mental health treatment preferences or instructions of an individual.

This document grants someone the authority to make health care decisions on your behalf in the state of Illinois.

This form is used for opting out of Workers' Compensation Coverage in Illinois.

This Form is used for making a request to deactivate Emergency Medical Services (EMS) in the state of Illinois.

This Form is used for recording on-the-job training for pesticide technicians in Illinois. It is used to track the skills and experiences gained during the training process.

This form is used for reporting incidents and accidents that occur in assisted living and shared housing facilities in Illinois. It helps to ensure the safety and well-being of residents, as well as provide documentation for regulatory requirements.

This document is used for obtaining a certificate of insurance for structural pest control in the state of Illinois. It is a necessary form for individuals or companies in the pest control industry to provide proof of insurance coverage.

This form is used for completing a medical questionnaire as part of the Illinois Adoption Registry process in Illinois. It collects important health information to help with the adoption process.

This form is used for keeping a record of the family health history in the state of Illinois.

This form is used for obtaining a dental examination certificate for school children in Illinois. (Spanish)

This Form is used for applying for a permit to construct, modify, or abandon a water well in the state of Illinois.

This Form is used for submitting a request for information under the Freedom of Information Act in the state of Illinois. It allows individuals to access and obtain records held by government agencies.

This Form is used for conducting public health home visits in Illinois to assess environmental health and identify potential lead exposure risks.

This document is used to request the location of special flood hazard areas in Illinois in order to assess potential flood risks.

This form is used for submitting an audiogram in the state of Illinois.

This Form is used for individuals in Illinois applying for an examination to become certified plumbing inspectors.

This Form is used for applying for an apprentice plumber's license in Illinois.

This Form is used for renewing the Child Support Personal History Statement for Emergency Medical Services (EMS) Systems in Illinois.

This document is a Certificate of Child Health Examination specific to the state of Illinois. It is used to verify a child's health status and is often required for enrollment in schools or child care centers.