Illinois Department of Public Health Forms

This form is used for requesting a grade evaluation of milk in a laboratory in Illinois.

This document is a questionnaire used to certify personnel working in milk or water laboratories in the state of Illinois.

This type of document is an application form for non-transport providers of emergency medical services in the state of Illinois.

This Form is used for applying to become an asbestos training provider in the state of Illinois.

This document is for applying to an EMS training program in Illinois. It provides the necessary information and forms for applicants to submit their application.

This Form is used for requesting reasonable accommodation for individuals with disabilities in the state of Illinois.

This form is used for authorizing the exchange of information in the Illinois Adoption Registry.

This form is used for birth parents in Illinois to express their preferences regarding the adoption of their child.

This document is used for obtaining a religious exemption to required immunizations and/or examinations in the state of Illinois. It allows individuals to indicate their religious beliefs and provide necessary documentation to opt out of these requirements.

This form is used to apply for the Illinois birth record of a deceased individual.

This form is used for applying for a birth record in Illinois. It is called VR180 Application for Illinois Birth Record.

This Form is used for applying to become a plumber's apprentice in an approved apprenticeship training program in Illinois, regulated by the U.S. Department of Labor.

This Form is used for submitting Project Manager's Report in the state of Illinois

This document is used for reporting incidents and accidents that occur in assisted living and shared housing facilities in the state of Illinois. It helps in maintaining records and ensuring the safety of residents.

This form is used for submitting a request for variance in Illinois. It serves as a cover sheet for the request.

This document is for obtaining approval from Medicare for an extension site of a Comprehensive Outpatient Rehabilitation Facility in Illinois.

This document is used for applying for a dispenser license under the Hearing Instrument Consumer Protection Program in Illinois.

This type of document certifies the child support payments related to irrigation in the state of Illinois.

This Form is used for a contractor in Illinois who performs irrigation work and is affirming that they have no employees.

This form is used for obtaining a surety bond for a corporation irrigation contractor providing lawn sprinkler systems in the state of Illinois. The bond ensures performance and compliance with relevant laws and regulations.

This form is used for keeping track of participants enrolled in a training course in Illinois. It helps organizers manage and maintain a roster of attendees for the course.

This form is used for applying for a permit to construct, alter, or extend a drinking water system in Illinois for non-community public water systems.

This form is used for applying for a State of Illinois Plumber's License Reciprocity with the City of Chicago License without examination.

This Form is used for reporting drowning, injury, illness, or incidents in Illinois.

This Form is used for reporting daily operations at swimming facilities in Illinois.

This form is used for retired plumbers in Illinois to apply for their license.

This Form is used for applying to become a registered State Closed Loop Well Contractor in Illinois.

This form is used to apply for a permit in Illinois to construct, modify, or seal a closed loop well system.

This form is used for applying to be certified in Illinois to conduct examinations for state closed loop systems.

This document provides guidance for schools and day care programs in Illinois on how to address and prevent the spread of COVID-19. It includes recommendations for mitigation measures, cleaning and disinfection, testing and contact tracing, and other important considerations.

This form is used for obtaining a certificate of dissolution of marriage, civil union or legal separation in the state of Illinois. It serves as an official document to legally end a marriage or civil union or to establish a legal separation.

This type of document is used for foreign LPNs or RNs who wish to apply to become a certified nurse aide in the state of Illinois.

This form is used for making a complaint about language access issues in the state of Illinois.

This document provides step-by-step instructions for collecting a stool specimen using a Cary Blair swab in Illinois for bacterial analysis.

This document is used for reporting serious injury incidents and communicable diseases in long-term care facilities in Illinois.