Illinois Department of Public Health Forms

This form is used for renewing or changing ownership of home health, home services, and home nursing agencies in Illinois.

This Form is used for recording a patient's preferences for life-sustaining treatment in Illinois. It is available in both English and Polish.

This Form is used for making medical treatment decisions in Illinois. It is available in both English and Spanish versions.

This Form is used for reporting tuberculosis cases in Illinois.

This document is essential for laboratories in Illinois that are part of the CLIA (Clinical Laboratory Improvement Amendments) Certification Program and need to make changes to their registered name, address or email. It provides instructions on how to update these critical details.

This document is used for keeping track of the inventory of rabies vaccines in Illinois. It helps ensure that there is an adequate supply of vaccines to prevent and treat rabies in the state.

This form is used for requesting laboratory tests for communicable diseases in Illinois.

This document is for the Illinois residents and is used to request and guide medical practitioners on life-sustaining treatment decisions. It is available in English and Chinese languages.

This Form is used for ordering life-sustaining treatment in Illinois. It is available in both English and Hindi languages.

This Form is used for the IDPH Uniform Practitioner Order for Life-Sustaining Treatment (POLST) Form in Illinois. It is available in both English and Korean languages.

This form is used for practitioners in Illinois to record a patient's decisions regarding life-sustaining treatment. It is available in both English and Chinese Simplified languages.

This type of document is the Uniform Practitioner Order for Life-Sustaining Treatment (POLST) form used in Illinois. It is available in English and Arabic.

This document is used in Illinois for patients to communicate their preferences for life-sustaining treatment. It is available in both English and French.