Douglas County Health Department
Douglas County Health Department
1250 E US 36 Highway | Tuscola, Illinois 61953
(217) 253-4137
  • Home
    • Home
    • Employee Listings
    • About Us
    • F.O.I.A.
    • H.I.P.A.A.
    • DCHD Forms
    • Career Opportunities
    • Past News & Updates
  • Board of Health
    • Board of Health Members
    • Meeting Minutes
    • Meeting Agendas
  • Calendar
  • COVID-19
    • COVID-19 Staff
    • COVID Dept Forms
    • COVID-19 Testing Appointments
    • COVID-19 Vaccination Clinics
    • Past COVID-19 Posts
    • Past COVID-19 Weekly Updates
  • Dental
    • Dental Clinic Staff Pg 1
    • Dental Dept Forms
  • Environmental
    • Environmental Staff
    • Food Sanitation
    • Real Estate Transfer Evaluations
    • Pest Control
    • Nuisance Control
    • Local Licensed Well Water Drillers
    • Plan Review
    • West Nile Virus
    • Temporary Food Permit
    • Septic Systems
    • Mold in Rentals
    • Tanning Salon Inspections
    • Rental Property Rights
    • Well Disinfecting
    • Soil Classifiers for Douglas County
    • Solid Waste Management
    • Safe Water
    • Environmental & Food Services Forms
    • Past Environmental Posts
  • I.T.
    • I.T. Staff
  • Emergency Prep & MRC
    • Emergency Prep/MRC Staff
    • Past Emergency Prep/MRC Posts
  • Nursing
    • Nursing Staff
    • Breastfeeding and Lactation Counseling
    • Diabetes
    • Family Case Management
    • Foreign Travel
    • Communicable Disease Program
    • Immunizations
    • Tuberculosis (TB)
    • Lead Poisoning Prevention
    • Women Infants Children
    • Women’s Health
    • Vision & Hearing Screenings
    • Past Nursing Posts
    • Flu Vaccination Info
  • Outreach
    • Outreach Staff
    • Harm Reduction Service
    • Medical Cannabis Program Info
    • Opioid Program Info
    • Freedom From Smoking
    • Tobacco Programs
    • Smoke Free Illinois
    • Past Outreach Posts
  • Helpful Links

DCHD Forms

General Forms

DCHD Job Application Douglas County Medical Reserve Corps Application

HIPAA Forms

Authorization for Release of Medical Information

 


Nursing Forms

Children’s Flu Vaccination Consent Form – English Adult Flu Vaccination Consent Form – English Children’s Flu Vaccination Consent Form – Spanish Adult Flu Vaccination Consent Form – Spanish Influenza Vaccine VIS

 


Dental Forms

Dental Registration Form

 


Environmental Forms

Septic Form Plan Review Application Temporary Food Permit Cottage Food Registration Form (PDF) Food Safety Plan (PDF) Cottage Food Self-Checklist (PDF)

 


COVID-19 Vaccine Forms

Johnson & Johnson Consent Form Johnson & Johnson EUA

 


Moderna Consent Form – English Moderna EUA – English Moderna Consent Form – Spanish Moderna EUA – Spanish

 


Pfizer Consent Form – English Pfizer Fact Sheet – English Pfizer Consent Form – Spanish Pfizer Fact Sheet – Spanish

 


 

About Us
Board of Health
Calendar of Events
COVID-19
Dental
Environmental
Information Technology
Emergency Prep & MRC
Nursing
Outreach
F.O.I.A.
H.I.P.A.A.
Links
Careers

Connect with us!

*Click the image to go to the social platform.



 



Hours of Operation

Main Office:

Monday-Friday 8AM to 4:45PM

Dental Clinic:

Monday-Thursday 8AM to 4:45PM

COVID-19 Contact Tracing:

Monday-Thursday 8AM to 4:30PM

Friday-Sunday 8AM to 12PM

COVID-19 Testing @ Tuscola Outlet Mall:

Monday-Thursday 8:30AM to 11:30AM, 12:30PM to 3:30PM

Friday 8:30AM to 12PM

DCHD Employees & BOH Members

  • Employee Listings
  • Board of Health Members
Home | Douglas County | Board of Health | DCHD Facebook | DCHD Twitter | DCHD Instagram |

© 2014-2022 Douglas County Health Department | Douglas County, Illinois
Manage Web Site
Web development by Kestrel Website Design | Site Map | Disclaimer | Privacy Policy

7ads6x98y