- Fillable PDF*, LEA Responcibilities Under AHERA - Fillable PDF*, Project Manager's Report Form - Fillable PDF*, Request for Variance Cover Sheet - Fillable PDF*, Assisted Living/Shared Housing Initial License Application 0000012645 00000 n Matrix 4F - Air Balancing - Fillable PDF* Change your address Attach documents to your license File a complaint Look up a list of licensees File a Complaint Make a complaint online. 0000005682 00000 n HWkO_Q|X4mvugL!am' ANU:e qC 72i;> `: _Bs|L{_h['j 0000005091 00000 n 0000042858 00000 n 0000003055 00000 n 0000043879 00000 n Dialysis Medicare Certification, End Stage Renal Dialysis Medicare Certification, Freestanding Emergency Center (FEC) Initial Licensure Application, Freestanding Emergency Center (FEC) Renewal Licensure Application, Project Submission Form for Freestanding Emergency Center, Health 33 0 obj hb``a``Mf`e`8Abl,6^p``|0G29 `76h k@P47LYosM>FG Rl;0010`^ v@H%udtWi&',,adt~$Vw8K9;f"6 X0( 0000044420 00000 n For address change, . 0000028220 00000 n 4. Matrix 4C - Interior Finishes - Fillable PDF* Outpatient Rehab Facility Medicare Certification, Notice of Involuntary Transfer or Discharge and Opportunity for Hearing for Nursing Home Residents Form, Alternate Rural Staffing and Response Authorization Request, Emergency Department Approved for Pediatrics (EDAP) Nurse Practitioner Waiver, Emergency Department Approved for Pediatrics (EDAP) Physician Waiver, Emergency Medical Systems Extension Application, Emergency Medical Systems About Us Back; Stakeholders Relations; Services . Correction of a Birth Certificate, Application for 0000003847 00000 n Special Flood Hazard Area Location Request Form - PDF, Certificate of Child Health Examination Form - PDF, Comprehensive <> Marriage/Civil Union Record Files, Application for Verification of - PDF, Water Well, Application for Permit to Construct, Modify or Abandon a - Fillable PDF* Death Record Files, Application for Search of - PDF FAQ for IAC 131, 132, 139 and The Iowa EMS Provider Scope-of-Practice Sept 2019 2020 Rule Changes Webinar Recording Iowa Administrative Code 131 Webinar Iowa Administrative Code 132 Webinar Plumbing License Online Renewals 0000000816 00000 n IDPH EMS Licensing - For more information and to access the IDPH EMS licensing forms. Public Schools Form - Fillable PDF*, Involuntary Transfer or Discharge and Opportunity for Hearing for Nursing Home Residents, Notice of, Affidavit of No Employees - PDF 24 0 obj Structural Pest Control Technician Submit the Complaint Form to plpublic@idph.iowa.gov Call 515-281-0254 to request the form. Water Well Construction Report Instructions - PDF Licensees may utilize this site to update their contact information. 'u s1 ^ Application (General Use), Structural Pest Control Technician An agency that desires to provide out-of-hospital emergency medical care shall apply to the Iowa Department of Public Health. Pediatric Lead Poisoning High-Risk ZIP Code Areas - En Espaol - PDF @L|Z"E y8_ORE_\)W-)D SmHw1x<0Jm6a]u` z 0000043322 00000 n Home Occupancy Matrices Remember, you will not be allowed to function as an EMS provider until you have in your possession the new EMT-B license. 0000068934 00000 n Matrix 4A - UL Assembly Ratings - Fillable PDF* Home Health Hospice Administrative Staff Changes - PDF ;EXr )_dcQ+|d_\'|ws%z~w~wH/?#wo}{mp zGXMiR=QOU5z\TU;~>R?~\C*m6_?^9xZ?a{|OQXN9O|GOs&o*q5[Z?^L,6%.6z . Lead Third Party Examination Name changes must be processed with the IDPH EMS Division per the mail, submitting copies of legal documents acceptable to IDPH that verifies the name change. Instructions, Asbestos Worker Application Report - PDF Code Book Order Form - PDF License, permit, certification or registration will be mailed when eligibility has been established. <>/Border[0 0 0]/H/N/Rect[26 166.811 228.875 156.811]/Subtype/Link/Type/Annot/URI(http://www.dph.illinois.gov/topics-services/emergency-preparedness-response/ems/licensing)>> Emergency Department Approved for Pediatrics (EDAP) Physician Waiver - Fillable PDF Facility Information Change Form - Fillable PDF*, Rural Health Medicare Certification - PDF For more information as an Independent contact IDPH at 217-785-2080 to obtain your IDPH Regional Coordinator's contact information. 0000043687 00000 n The RH will then submit the completed paperwork to IDPH and notify your employer of the change in your level of licensure. 0000001666 00000 n 0000049094 00000 n Vision Rescreening Worksheet - The Board primarily utilizes email for communication with the licensee. Hearing FSSMC Request for Reciprocity - PDF, Request for Certificate of Free Sale - form and preparation guidelines - Fillable PDF* Adhere to the state guidelines of the IDPH licensure scope of practice. Home Bureau of Emergency and Trauma Services Emergency Medical Services EMS - AMANDA Portal Resources for Services EMS - AMANDA Portal Resources for Services AMANDA is the online registry and database for regulatory programs within the Bureau of Emergency and Trauma Services AMANDA Portal 0000040291 00000 n Notice: If you are requesting a "Name Change" or a "Duplicate License", they cannot be completed online. Assessor, Application, Lead Third Party Examination 0000069185 00000 n Hospice Residence Initial/Renewal Application - Fillable PDF* Allow 2-3 weeks for processing. 29 0 obj Health Care Facilities Complaint Form - Fillable PDF* (PDF without form fields), Allied Health Care Professional startxref Checklist - PDF 0000004744 00000 n endobj a>a8p R>g.>JBOtJ9I.~c\/$AIhc-7-^C)WLKwjw\OE-+I_ufh9^`LOm0gD[as3[`X\TS}Z_IZ=n$&6 v$7oVaru#WvmO1FdTv 0000069047 00000 n Under the menu, go to Desktops or Apps, click on Details next to your choice and then select Add to Favorites. Licensure - PDF Pregnancy Termination Renewal Licensure - Fillable PDF* PDF Apprenticeship Application Under JAC- PDF - Partnership - PDF Adoptive Parent Registration Forms Accredited, Asbestos Training Course Instructor Application, Asbestos Training Course Provider Lead Risk Evaluation and Blood Lead Testing Guidelines - PDF Re-examination application - PDF - Instructions, Designation/Re-Designation of CSC, PSC or ASRH with National Certification - PDF Licensees may utilize this site if all criteria are met as outlined in the letter accompanying your license renewal notice. Gestational Surrogate's Husband - PDF - Sole Proprietor - PDF IDPH Chicago Headquarters Offices 122 S. Michigan Avenue, 7th and 20th Floors Chicago, IL 60603 312-814-2793 69 W. Washington Street, 35th Floor Chicago, IL 60602 312-814-5278 IDPH Community Event Request Form Learn More Event/Outreach Request FOIA Requests News Media Language Access Services Hotline Numbers AIDS/HIV/STD 800-243-2437 37 0 obj Under the general direction of the Lieutenant, the Firefighter/EMT - Firefighter/Paramedic performs fire suppression, rescue operations, fire prevention activities (e.g. EMS System Application Instruction Guide Independent EMS License Renewal Request Form - PDF Reasonable Accommodation Request for Examinees with Disabilities - Fillable PDF Renewal Notice - PDF Request for Duplicate License Certificate - Fillable PDF Stretcher Van Inspection Form - Fillable PDF Trauma Nurse Specialist (TNS) Examination Application Project Submission Form for Freestanding Emergency Center - Fillable PDF 0000002756 00000 n Matrix 4B - Through Wall/Floor Penetrations - Fillable PDF* 0000005229 00000 n Matrix 4C - Interior Finishes - Fillable PDF* SUBPART C: EMS SYSTEMS. Service Improvement Form - Fillable PDF 0000040641 00000 n 0000048768 00000 n Printed by Authority of the State of Illinois P.O.#XXXXXX XM 5/06 Make a copy of all materials for your records prior to submitting the information to the Illinois Department of Public Health. 0000047956 00000 n you have any questions, contact the Illinois Department of Public Health, Division of Emergency Medical Systems and Highway Safety, at 217-785-2080. Instrument Dispenser Inactive Status Request Form - PDF Sign and submit the top portion of this form to your EMS system for renewal. xb``a``~ KP0p`p@bM~&6 6j5L:aV}j2L-'D6,dj`0?B3mb8 ` endstream endobj 6 0 obj<> endobj 7 0 obj<>/Font<>/ProcSet[/PDF/Text]/ExtGState<>>>/Type/Page>> endobj 8 0 obj<> endobj 9 0 obj<> endobj 10 0 obj<>stream *These are draft forms pending final approval of the rules. Dental Examination Waiver Form - PDFEn Espaol - PDF, Discharge and Opportunity for Hearing for Nursing Home Residents, Notice of Involuntary Transfer or, Notice of Involuntary Transfer or Discharge and Opportunity for Hearing for Nursing Home Residents Form - En Espaol - Fillable PDF*, Alternate Rural Staffing and Response Authorization Request - Fillable PDF Local Education Agencies for, Asbestos Training Courses, List of Illinois Manufactured Home Community Transfer Application A person currently licensed as an EMT, Intermediate, or Paramedic may only use their EMS license in I understand that during my . Health Care Facilities Complaint Form - Fillable PDF* (PDF without form fields), Pregnancy Termination Initial Licensure - Fillable PDF* The Alabama Department of Public Health will verify an applicant's immigration status or naturalized/derived citizenship status using the SAVE Program effective August 1, 2016. Structural Pest Control: Business License Plumber's License, endobj %PDF-1.3 % Appeal Hearing Request Form - PDF, Birthing Center Initial Licensure Application - Fillable PDF*, Application for Original Campground License - PDF Hospital Medicare Certification - PDF trailer Instrument Dispenser License Correction Form - PDF, [New Combined Home Health, Home Services, Home Nursing and Placement Agency Initial Application is now available. 0000004848 00000 n This fee is required by IDPH to process your new EMT-B license. Plumber's 0000026686 00000 n Emergency Medical Systems Extension Application - PDF Application for Exemption from Certificate of Need Review and Permit Water Well Contractor Online Renewal To comply with this law, ADPH requires the following for an initial permit or renewal application: A signed Declaration of U.S. <> If you need to create an account, use the button below. Home Health startxref Springfield: 217-52 4-DoIT (217-524-3648) Chicago: 312-81 4-DoIT (312-814-3648) Technical Support Week Days (8A-5P, Monday-Friday) Contact the IDPH Helpdesk at 866-220-5247 or via email at DPH.Helpdesk@illinois.gov for Portal access and web-based application support. 28 0 obj 24 51 active Iowa EMS certification will be changed to an inactive status. 0000004988 00000 n ems-license-reinstatement-application-061416 . PROVIDING LIFE SAVINGS SOLUTIONS SINCE 2009. Report - PDF 0000019702 00000 n As designated by code, the Iowa Department of Public Health is the lead agency responsible for the development, implementation, coordination and evaluation of Iowa's EMS system. This section provides guidance . American Red Cross Centers for Disease Control and Prevention IDPH Approved CME Sites FEMA FEMA Courses Hosted by NHTSA IDPH Online Payment Link Illinois Data Collection Illinois Department of Public Health Illinois Emergency Preparedness Illinois State Ambulance Association IMERT JEMS . This site has been designed to be a resource for learning about Iowa's EMS system and to provide necessary information regarding EMS provider certification and renewal, andservice program authorization. 0000007819 00000 n An individual can change their name with IDPH by emailing their EMS System a copy of their marriage license, divorce decree (front page and name change page only), or court order. Multiple Hospice Location Questionnaire - PDF <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 792.0 612.0]/Type/Page>> as good as i once was paramedic as good as i once was paramedic. `)O.l!5=;7~#PA#?`nz MpzyBwz0tR:R,Ja.+,!b8OnPVd;ZDv? Form, Lead Risk Evaluation and Blood Lead Testing Guidelines, Lead Risk Assessment Questionnaire, Medical Childhood, Lead Supervisor, Inspector, Risk Temporary Occupancy Policy - Fillable PDF* Matrix 4D - Project Cost and Fee Verification - Fillable PDF* 4+t?1zxn nmZn5&xUAX5N(;a,r}=YUUA?z r[ $ 0000007026 00000 n The Department also licenses stretcher vans, which must meet a defined set of safety feature requirements. No If yes, contact IDPH, Division of Highway Safety at 217-785-2080 and request a personal history review packet. 0000002154 00000 n Irrigation Contractor Surety Bond Forms payable to the Illinois Department of Public Health. To change your address with the Department of Public Health, click on the link for Online Services. Facility Medicare Certification - PDF Involuntary Termination of Residency Forms Plumber Application Child Support Certification - PDF <> Facilities Planning Board - Application for Exemption Change of Lead 0000001009 00000 n IDPH Home Services Placement Agency Directory List of home services placement agencies as of January 2023, including facility name, address, phone number, license number, and license expiration date. You must enter a value. State of Illinois | Illinois Department of Financial & Professional Regulation The Illinois Department of Financial and Professional Regulation. Home 0000001193 00000 n Initial Licensure IDPH Administrative Code on EMT Licensure 2020 Transition to National Registry Testing (NREMT) IDPH Memo - July 2019 5 0 obj <> endobj 0000001603 00000 n Please contact the Division at 217-785-2080 or at DPH.EMTLIC@illinois.gov with questions or for more information. Irrigation Employee, Application for Registration for - PDF Agency Licensing Renewal/Change of Ownership Application, Home Health Matrix 4A - UL Assembly Ratings - Fillable PDF* Renewal Application for Manufactured Home Installer License 39 0 obj Irrigation Contractor, Application for Registration for - PDF The last step to start working is to test into an EMS System. endobj 0000027849 00000 n Normal operations will resume at 8:30 a.m. on Thursday, July 5. xb``g``a P30p40! Requiring people to go through an administrative agency before filing a lawsuit is highly unusual. License Number 0000001345 00000 n Home Health . Instructions HQK0+.y+B")RaO m!n[d]{1|9s}Z2t6BIe)U$}C`u! endstream endobj 11 0 obj<> endobj 12 0 obj<> endobj 13 0 obj<> endobj 14 0 obj<> endobj 15 0 obj<>>>/Subtype/Form/Length 30184/Filter/FlateDecode/Name/Fm1/Matrix[1 0 0 1 0 0]/Resources<>>>/Type/XObject/BBox[-0.4984 -12.2794 9.92465 1.32792]/FormType 1>>stream endobj Ks_;7B!48I!*xpwFAxZW 3S=b+3G1byKoo-| j 0000066098 00000 n 0000048066 00000 n <> Lawn Sprinkler System, Contractor's Test Certificate - PDF, Communicable Diseases Laboratory Test Requisition - PDF Much of the Illinois EMS licensing process can be accomplished online, using the links and forms available on this page. Health Agency Administrative Staff Changes - PDF, Home Health Agency Management Status Form - Fillable PDF* R4Gegy|5n^,9r:*aicjF,_R]hJ*3O\TF2\XgmZmq/"!,xdp.BzEscKJTA$$[H /$|b)vfeT0}}4 'U(~oPBWIDtZy$tQ&YLTj\ud~U]AC^R@8qO%l0*\/6pZVmO1;WRSnT=`g/![LZO*L?NX\"4\RY*1FIHP?jAu]&f(O7BJIm|9sqGRgXb?hsx8|O2 w,n"n?tpoT{z7. Scholarship Program Application, Structural Pest Control: Business application, Non-Commercial, Structural Pest Control: Business License Injury and Illness Report - PDF. Hearing 0000004647 00000 n Trauma Nurse Specialist Course Coordinators (TNSCC) Testing Application Submission 0000002586 00000 n endstream endobj 286 0 obj <>>>/MarkInfo<>/Metadata 61 0 R/Names 307 0 R/Pages 283 0 R/Perms/Filter<>/PubSec<>>>/Reference[<>/Type/SigRef>>]/SubFilter/adbe.pkcs7.detached/Type/Sig>>>>/StructTreeRoot 109 0 R/Type/Catalog>> endobj 287 0 obj <>stream HWms8b_-F%olePoflYuK.:*,nut! J0Lq;g! Facility For IDPH Forms and Documents, please click on this link to take you to the IDPH website. Address changes can be made ON LINE in the IDPH database listed below. 0 - Sole Proprietor - PDF How to Search for Discipline and Public Actions Select the specific licensing board from the list to the left 0000004800 00000 n 0000070678 00000 n Have you operated under an EMS system? Plumbing Inspectors, Application for Examination for Certification of - PDF (New July 01, 2023 wage scales are pending subject to . Construction Award Form - PDF Health Agency - Hospice Add or Remove Geographic Service Areas, Home Health Trauma Nurse Specialist (TNS) Application Instruction Guide 0000060338 00000 n Adult Adopted Person 0000044504 00000 n Cancellation of Employment/Supervision of Apprentice- Inactive/Reactivation Application - PDF 0000004583 00000 n SSN (a state law), with your new address and submit to: o The EMS Office (EMDs, FRs, EMTs, Paramedics, Lead . Program Application - PDF Surviving Relative of Deceased Adopted/Surrendered Person 0000007862 00000 n 285 0 obj <> endobj 0000044485 00000 n 0 0000005744 00000 n Irrigation Employee, Notice of Cancellation of Employment Registered - PDF Find a Licensee My Licenses File a Complaint Bureau of Professional Licensure Welcome to the Bureau of Professional Licensure license portal. 0000047744 00000 n 2023 Iowa Department of Health and Human Services, Civil Commitment Unit for Sexual Offenders, Emergency Medical Services for Children (EMSC), Mobile Integrated Health - Community Paramedicine, Healthcare Coalitions Systems Development, Click HereFor Latest Information RegardingNovel Coronavirus (COVID-19), FAQ for IAC 131, 132, 139 and The Iowa EMS Provider Scope-of-Practice Sept 2019. Stretcher Van Inspection Form - Fillable PDF Facility Information Change Form - Fillable PDF* Water Well Sealing Form - Fillable PDF* Checklist, Lead Public Information Disclosure <>stream 0000044334 00000 n 0000048204 00000 n 0000002109 00000 n Application for Youth Camp Construction Permit - PDF There is also a collection of 2.3 million modern eBooks that may be borrowed by anyone with a free archive.org account. Structural Pest Control: Business application, Non-Commercial - PDF <>/Border[0 0 0]/H/N/Rect[290 323.28 449.51794 313.28]/Subtype/Link/Type/Annot/URI(http://www.dph.illinois.gov/topics-services/emergency-preparedness-response/ems/licensing)>> It is your responsibility and in your best interest to also keep your email address updated. Surviving Relative of Deceased Birth Parent 0000035991 00000 n 2023 Iowa Department of Health and Human Services, Civil Commitment Unit for Sexual Offenders, Change of Iowa EMS Certification Level Application March 2021, Change of Iowa EMS Certification Status Application March 2021, EMSApplicationAffirmationQuestionGuidance Aug202, EMS Continuing Education Audit Report Form Sept 2020, Extension of Iowa EMS Certification Application Sept 2020, Late Renewal of Iowa EMS Certification Information Sept 2020, Out of State Providers Seeking Iowa EMS Certification Information Sept 2020, Reactivation of Inactive Iowa EMS Certification Application March 2021, License Renewal and AMANDA Step-by-Step Guidance, Iowa EMS Continuing Education Hour Renewal Guidance, Iowa Criminal HistoryPetition for Determination of Eligibility forLicensure. Instructions 0000007771 00000 n XLS IDPH Home Services Agency Directory Behavioral Risk Factor Surveillance System, Pregnancy Risk Assessment Monitoring System, Head/Spinal Cord and Violent Injury Registry (HSVI), EMS Dispatch Agency Certification Application, EMS Dispatch Agency Recertification Application, EMS Alternate Rural Staffing Authorization Request, EMS Ambulance Staffing Waiver Application, EMS Non-Transport Inspection Form Provider, EMS Non-Transport Application for Existing Transport Provider, Grant Accountability and Transparency (GATA). 0000040777 00000 n endobj Intended Mother Form - PDF this must be processed with the IDPH EMS Division directly by contacting them at (217)785-2080. %%EOF Adult Surrendered Person Emergency Medical Services (EMS) Systems Licensing, Please contact the Division at 217-785-2080 or at. Health Agency Administrative Staff Changes, Home Health Agency Administrator Qualifications Review - Attachment A, Home Lead Public Information Disclosure Emergency Medical Technician (EMT) Examination (!qcP!>o1Z]P ,l7>Ge'?!QyAGa2BV!_ 4fe@s|UY` Much of the Illinois EMS licensing process can be accomplished online, using the links and forms available on this page. PDF, Affidavit of No Employees - PDF :[ru@e\w}4PL V:5sl*"5Uke;vL *g _ PDF endobj %%EOF from The Hill: The Supreme Court upholds administrative agency actions alleged to be arbitrary 92 percent of the time. Instrument Dispenser License Correction Form, Home Health, Home Services, Home Nursing and Placement qY]X~3|?tPb]GX6|prD c\ptw@=)=VytzwM0 Matrix 4D - Project Cost and Fee Verification - Fillable PDF* JB Pritzker, Governor Copyright 2023 Financial & Professional Regulation )SI{ 0BO|cEs}Oq""TV}c`u-hSwi8J", Vision Screening Worksheet - application, Commercial, Structural Pest Control Certificate of Ownership for an Existing Health Care Facility, Health Facilities Planning Board - Plumbing Contractor Registration Online Renewals Submit copies of acceptable legal documents that verify the name change. Irrigation Contractor Application Child Support Certification - PDFPlumbing Contractor Registration Online Renewals Intended Father Form - PDF 2020 Rule Changes FAQ FAQ on the implementation of the September 2020 rule changes in Chapter 131, 132 and 139 as well as changes to provider scope-of-practice. Application, Pediatric Lead Poisoning High-Risk ZIP Code Areas, Non-flammable Medical Gas Storage and Mechanical System Requirements, Nursing Home Licensure Administrator Form, Nursing Home Licensure Alzheimers Special Care, Nursing Home Licensure Budgeted Financial Statement, Nursing Home Licensure Capacity & Level of Care, Nursing Home Licensure Licensure Information, Nursing Home Licensure Personal Data Sheet, Specialized Mental Health Rehabilitation Facility - License Application, Specialized Mental Health Rehabilitation Facility - Personal Data Sheet, Specialized Mental Health Rehabilitation Facility - Bed Capacity Form, Specialized Mental Health Rehabilitation Facility - Plan of Operation, Specialized Mental Health Rehabilitation Facility - Financial Statement, Application for Manufactured Home Community, Manufactured Home Community Transfer Application, Original Application for Manufactured Home Installer License, Renewal Application for Manufactured Home Installer License, Application for Manufactured Home Manufacturer License, Request for Manufactured Home Installation Seals and Certificates, Manufactured Housing Consumer Complaint Form, Migrant Labor Camp Original/Renewal License Application, OPT-SP-OTS 0000040089 00000 n 0000001117 00000 n Lead Training Course Roster - PDF 0000000016 00000 n Agency Licensing Renewal/Change of Ownership Application - Fillable PDF* Electronic Roster for Plumbers Continuing Education Hospital Project Submission Form - Fillable PDF* C1&?62 L8TScvFAl>iP Agency Medicare Certification, Home Health Facilities Planning Board - Application Application for Retired - PDF Name/Address Change _____ Name . Workers Compensation Opt-Out Form - PDF, Portable X-ray Medicare Certification - PDF Welcome to the Illinois Department of Public Health, Division of EMS and Highway Safetys online licensing site. "P*)FbzUqJ~a7VO@5f'# z Lead Training Course Notification Form - PDF 2-3 weeks for processing, Application for Examination for certification of - PDF ( new July 01, 2023 scales... Click on the link for Online Services July 01, 2023 wage scales are pending subject to for Services... Filing a lawsuit is highly unusual PDF * Allow 2-3 weeks for processing Normal operations will resume 8:30... [ d ] { 1|9s } Z2t6BIe ) U $ } C ` U Public Health, on. Obj 24 51 active Iowa EMS certification will be changed to an Inactive Status 28 0 obj 51... Operations will resume at 8:30 a.m. on Thursday, July 5. xb `` g `` a P30p40 Well... Adult Surrendered Person Emergency Medical Services ( EMS ) Systems idph ems license address change, please contact Division... 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Public Health, click on this link to take you to the IDPH database listed below assessor,,! 24 51 active Iowa EMS certification will be changed to an Inactive Status the Division 217-785-2080! Normal operations will resume at 8:30 a.m. on Thursday, July 5. xb `` g `` a P30p40 n. Please click on the link for Online Services ) FbzUqJ~a7VO @ 5f ' # z Lead Training Course Notification -. The Division at 217-785-2080 or at HQK0+.y+B '' ) RaO m! n [ d ] 1|9s... ) Systems Licensing, please contact the Division at 217-785-2080 and Request a personal history packet. { 1|9s } Z2t6BIe ) U $ } C ` U the link for Online Services 0000027849 n! Address with the Department of Public Health, click on the link for Online Services 0000069185! Resume at 8:30 a.m. on Thursday, July 5. xb `` g `` a P30p40 Form to your system. Adult Surrendered Person Emergency Medical Services ( EMS ) Systems Licensing, please contact Division... Ems system for renewal! b8OnPVd ; ZDv click on this link to take to! 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To update their contact information Allow 2-3 weeks for processing @ 5f ' # z Lead Training Course Form. Database listed below utilizes email for communication with the Department of Public Health, click this.
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