Form Center

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Public Use Forms

  1. 2019 Community Health Needs Assessment (CHNA) and 2020-2022 Community Health Improvement Plan (CHIP) Feedback Form

    Complete this form to provide feedback for the 2019 Community Health Needs Assessment (CHNA) and the 2020-2022 Community Health... More…

  2. Cottage Food Operation Registration

    Complete this form to register as a Cottage Food Operation.

  3. Public Health Complaint Form
  4. Request a Workplace or Community Flu Clinic

    Complete this form to request a community flu clinic at your organization or within your community.

  5. Smoke-Free Housing Directory Registry

    Complete this form to list your smoke-free property in the Smoke-Free Housing Directory.

  6. Zika Virus Disease Request for Testing

    PHYSICIAN USE ONLY Please fill out the following form to submit a request for Zika Virus Disease Testing. Please print your completed... More…

  1. Contact Us

    Let us know if you have a question, comment, or request.

  2. Foodborne & Waterborne Illness Investigation Questionnaire

    Individuals are required to provide information about their illness and eating/drinking habits as part of a foodborne illness... More…

  3. Request a Health Presentation

    Complete this form to request a health presentation at your organization.

  4. Request Us at Your Health Fair or Community Event

    Complete this form to request us at your health fair or community event.

  5. Submit a Smoking Complaint

    Complete this form to report a suspected Smoke-Free Illinois Act violation observed in McLean County.