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This document is for waiving the requirement for complete lead service line replacement in Illinois.

This Form is used for waiving the requirement of an eye examination in Illinois.

This form is used for applying for a non-commercial business license in the field of structural pest control in the state of Illinois.

This form is used for abstracting medical charts related to cases of pediatric hepatitis of unknown cause in the state of Illinois.

This tool is used to screen visitors for Covid-19 in the state of Illinois. It helps identify potential symptoms and risk factors to help prevent the spread of the virus.

This Form is used for requesting an exemption from the vision exam requirement in Illinois.

Este informe del examen de la vista es específico para el estado de Illinois. Proporciona los resultados y detalles del examen de la vista realizado en Illinois.

This document is used for tracking the monthly hours worked by individuals in the Senior Community Service Employment Program in North Carolina.

This document provides instructions for collecting a stool specimen for Norovirus analysis in Illinois. It guides patients on how to properly collect and submit their sample for testing.

This document provides instructions for the patient on how to collect a stool sample for bacteria analysis using a Cary-Blair vial. It is specific to Illinois.

This document provides instructions for patients in Illinois on how to collect a stool specimen for bacterial analysis using a Cary Blair vial.

This type of document is a Directly Observed Therapy (DOT) Agreement for the Treatment of Tuberculosis (TB) in Illinois.

This type of document is a Patient Treatment Release Form specifically for use in Illinois. It is used to give consent for medical treatment and release healthcare providers from liability.

This form is used for determining the income eligibility of a child care center to participate in the Child and Adult Care Food Program (CACFP) in Vermont.

This document is a questionnaire for gathering information about multiple hospice locations in Illinois. It is used to collect data about various hospice facilities in the state.

This Form is used for applying to the Low Income Energy Assistance Program in North Carolina for assistance with energy costs. (Spanish)

This Form is used for submitting an Administrative Adjustment Request in the state of Arizona.