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Illinois Department of Public Health PROOF OF SCHOOL DENTAL EXAMINATION FORM To be completed by the parent (please print): Students Name:LastFirstMiddleBirth Date:/ Address:StreetCityZIP Code-name
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The Illinois Department of Public Health is a state agency responsible for protecting the health and safety of the people of Illinois.
Certain healthcare facilities and providers in Illinois are required to file reports with the Illinois Department of Public Health.
To fill out the Illinois Department of Public Health forms, healthcare facilities and providers must provide detailed information about their operations and patient care.
The purpose of the Illinois Department of Public Health is to monitor and improve public health outcomes in Illinois.
Information such as patient demographics, diagnoses, treatments, and outcomes must be reported on the Illinois Department of Public Health forms.
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