Douglas County Health Department
Douglas County Health Department
1250 E US 36 Highway | Tuscola, Illinois 61953
(217) 253-4137
  • Home
  • About Us
  • Board of Health
  • In and Around Douglas County, Illinois – Summer 2019
  • Now Hiring
  • Dental Clinic
  • Environmental Health
  • Informative Resource Links for Douglas County, IL and State of Illinois
  • Nursing Division
  • Programs & Services
  • Visit or Contact Us

Medical & Dental Forms, Applications, and Surveys

Forms and Applications and Policies

√  Current Community Surveys for Douglas County, Illinois

DCHD Job Application

DCHD_MRC_APPLICATION

Immunization Forms

New Flu Consent Form

Child Flu Consent Form 2018

Info Release

Communication Consent

Questionnaire

downloadVFC – Vaccinations for Children Program

downloadDental Registration Forms

Dental Exam Form

downloadTemporary Food Permit

HIPAA Consent Forms

HIPAA Policy

downloadSeptic

downloadPlan Reviews

School/Sports Physical Exam Form

School Dental Exam Form

 GoodLifeFair_Registration_2019

 

Contact or Visit Us
Public Events
Forms
Dental Clinic
Nursing
Environmental
Medical Reserve Corps
Careers
Links

Connect With Us

Home | Calendar | Douglas County | Board of Health | DCHD Facebook | DCHD Twitter | DCHD G+ | DCHD Instagram |

© 2014-2018 Douglas County Health Department | Douglas County, Illinois
Manage Web Site
Web development by Kestrel Website Design | Site Map | Privacy Policy

7ads6x98y