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Hamilton County Health Department

Hamilton County Health Department

  • Services
    • Birth and Death Certificates
    • Communicable Disease/TB
    • Emergency Preparedness
      • MRC Program
    • Environmental Services
      • Bed Bug Info
      • Nuisance Control
      • Private Sewage and Water Supplies
      • Tanning Bed Regulation and Inspection
    • Family and Children Services
      • Family Case Management Program
      • Women, Infants and Children (WIC)
        • Breastfeeding Peer Counselor Program
    • Food Sanitation
    • Immunizations
    • Smoke Free Illinois
  • About HCHD
    • Board of Health Members
    • Contact Us
    • Links of Interest
    • Local Links
    • Staff
    • Forms

Forms

The following is a list of forms frequently used by our office. Please contact our office if you have any questions.

HCHC HIPPA FORMDownload
AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATIONDownload
HEMATOCRIT AND LEAD SCREENING CONSENTDownload
TB FORMDownload
VACCINE ADMINISTRATION RECORDDownload