Contact IDPH Medical Services Division

This form should be used for questions from health care providers to IDPH Medical Services Division regarding IDPH resources, and is not intended to provide clinical guidance.

Date Submitted

mm/dd/yyyy

First name

Last Name

Email Address

Telephone Number

Organization:

Is this Urgent (response requested within one (1) business day)?

Route To

Area of Inquiry:

Reportable Condition

IDPH Resources

Health Advisory

Other

Inquiry Details:

*

Send me a copy of my responses

Powered by

Privacy Policy

Report Abuse