Documents & Forms

Doc app

Document Center

The Document Center provides easy access to public documents. Click on one of the categories below to see related documents or use the search function.

Categories always sorted by seq (sub-categories sorted within each category)
Documents sorted by HEADER in Descending Order within category

Administration Documents14 documents

  • Whiteside County Community Health Clinic Governing Council Bylaws
    document Header Whiteside County Community Health Clinic Governing Council Bylaws
  • Whiteside County Board of Health Bylaws
    document Header Whiteside County Board of Health Bylaws
  • Patient Grievance Form.docx
    document Header Patient Grievance Form.docx
  • Notice of Privacy Practices.pdf
    document Header Notice of Privacy Practices.pdf
  • Job Application.pdf
    document Header Job Application.pdf
  • Freedom of Information Act Request Form.pdf
    document Header Freedom of Information Act Request Form.pdf

Agendas & Minutes2 documents

  • CHC Governing Council
    document Header CHC Governing Council
  • Board of Health
    document Header Board of Health

Board Calendars6 documents

  • Governing Council Schedule of Meetings 2023
    document Header Governing Council Schedule of Meetings 2023
  • Governing Council Schedule of Meetings 2022
    document Header Governing Council Schedule of Meetings 2022
  • Governing Council Schedule of Meetings 2021
    document Header Governing Council Schedule of Meetings 2021
  • Board of Health Schedule of Meetings 2023
    document Header Board of Health Schedule of Meetings 2023
  • Board of Health Schedule of Meetings 2022
    document Header Board of Health Schedule of Meetings 2022
  • Board of Health Schedule of Meetings 2021
    document Header Board of Health Schedule of Meetings 2021

Clinic Forms28 documents

Behavioral Health Forms12 documents

  • Verification of Income
    document Header Verification of Income
  • Pediatric Symptom Checklist (For Parent to Complete)
    document Header Pediatric Symptom Checklist (For Parent to Complete)
  • Patient Information
    document Header Patient Information
  • Patient Health Questionnaire - Adult
    document Header Patient Health Questionnaire - Adult
  • Notice of Privacy Practices
    document Header Notice of Privacy Practices
  • Medical History
    document Header Medical History
  • Informed Consent
    document Header Informed Consent
  • Child-Adolescent Intake Form (For Parent to Complete)
    document Header Child-Adolescent Intake Form (For Parent to Complete)
  • Authorization to Schools
    document Header Authorization to Schools
  • Authorization - Pre-Filled
    document Header Authorization - Pre-Filled
  • Authorization - Former Treatment
    document Header Authorization - Former Treatment
  • Adult Symptoms - Self Rating Form
    document Header Adult Symptoms - Self Rating Form

Dental Forms4 documents

  • Verification of Income and Family Size.pdf
    document Header Verification of Income and Family Size.pdf
  • Patient Information
    document Header Patient Information
  • Notice of Privacy Practices
    document Header Notice of Privacy Practices
  • Dental Medical History
    document Header Dental Medical History

Family Planning6 documents

  • STD Risk Assessment Survey
    document Header STD Risk Assessment Survey
  • Reproductive Life Plan
    document Header Reproductive Life Plan
  • Notice of Privacy Practices
    document Header Notice of Privacy Practices
  • Family Planning Initial Medical History
    document Header Family Planning Initial Medical History
  • Family Planning Demographics
    document Header Family Planning Demographics
  • Change in Billing
    document Header Change in Billing

Medical Forms6 documents

  • Verification of Income and Family Size.pdf
    document Header Verification of Income and Family Size.pdf
  • Patient Information
    document Header Patient Information
  • Patient Health Questionnaire - Adult.pdf
    document Header Patient Health Questionnaire - Adult.pdf
  • Patient Health Questionnaire - Adolescent.pdf
    document Header Patient Health Questionnaire - Adolescent.pdf
  • Notice of Privacy Practices.pdf
    document Header Notice of Privacy Practices.pdf
  • Medical History Form.pdf
    document Header Medical History Form.pdf

Fee Schedules7 documents

  • WCHD - Immunization Fees
    document Header WCHD - Immunization Fees
  • WCHD - Environmental Health Fees
    document Header WCHD - Environmental Health Fees
  • WCCHC - Medical Clinic Special Fees
    document Header WCCHC - Medical Clinic Special Fees
  • WCCHC - Medical Clinic Fees
    document Header WCCHC - Medical Clinic Fees
  • WCCHC - Dental Clinic Fees.pdf
    document Header WCCHC - Dental Clinic Fees.pdf
  • WCCHC - Dental Clinic Fees 2
    document Header WCCHC - Dental Clinic Fees 2
  • Animal Control Fee Schedule
    document Header Animal Control Fee Schedule

Health Department Documents31 documents

Environmental Links8 documents

  • WHITESIDE COUNTY'S FOOD ESTABLISHMENT LOOK-UP
    document Header WHITESIDE COUNTY'S FOOD ESTABLISHMENT LOOK-UP
  • WHITESIDE COUNTY HEALTH CODE
    document Header WHITESIDE COUNTY HEALTH CODE
  • WATER WELL CONSTRUCTION REPORT
    document Header WATER WELL CONSTRUCTION REPORT
  • WATER WELL CONSTRUCTION CODE
    document Header WATER WELL CONSTRUCTION CODE
  • Septic system restrictions in flood plains.pdf
    document Header Septic system restrictions in flood plains.pdf
  • PRIVATE SEWAGE DISPOSAL CODE
    document Header PRIVATE SEWAGE DISPOSAL CODE
  • ILLINOIS WATER WELL PUMP INSTALLATION CODE
    document Header ILLINOIS WATER WELL PUMP INSTALLATION CODE
  • FOOD SERVICE SANITATION CODE
    document Header FOOD SERVICE SANITATION CODE

Food Program20 documents

  • Websites for food worker cards.pdf
    document Header Websites for food worker cards.pdf
  • Temporary Food Permit 2019.pdf
    document Header Temporary Food Permit 2019.pdf
  • Temperature Log.pdf
    document Header Temperature Log.pdf
  • Temp Food Guidelines.pdf
    document Header Temp Food Guidelines.pdf
  • Retail Food Establishment Application.pdf
    document Header Retail Food Establishment Application.pdf
  • Pre openining Requirements Mobile Food Units.pdf
    document Header Pre openining Requirements Mobile Food Units.pdf
  • Food Service Evals 2017 Jan through Oct.pdf
    document Header Food Service Evals 2017 Jan through Oct.pdf
  • Food Establishment Plan Review Guideline.pdf
    document Header Food Establishment Plan Review Guideline.pdf
  • Food Establishment Plan Review Flow Chart.pdf
    document Header Food Establishment Plan Review Flow Chart.pdf
  • Food Date Labels Avery 5160.pdf
    document Header Food Date Labels Avery 5160.pdf
  • Consumer Advisory Sign.pdf
    document Header Consumer Advisory Sign.pdf
  • Consumer Advisory Sign Spanish.pdf
    document Header Consumer Advisory Sign Spanish.pdf
  • Bake Sale Guidelines.pdf
    document Header Bake Sale Guidelines.pdf
  • 2016 Food Service Evals.pdf
    document Header 2016 Food Service Evals.pdf
  • 2016 food inspections.pdf
    document Header 2016 food inspections.pdf
  • 2016 Food Cert Course Providers.pdf
    document Header 2016 Food Cert Course Providers.pdf
  • 2015 Food Inspections.pdf
    document Header 2015 Food Inspections.pdf
  • 2014 Food Service Inspection Report.pdf
    document Header 2014 Food Service Inspection Report.pdf
  • 1st Quarter Food Service Evals 2017.pdf
    document Header 1st Quarter Food Service Evals 2017.pdf
  • 1-2017 Food Cert Course Providers.pdf
    document Header 1-2017 Food Cert Course Providers.pdf

Tanning Facility Permit and Links2 documents

  • Tanning poster.pdf
    document Header Tanning poster.pdf
  • Tanning Facility Permit Act.pdf
    document Header Tanning Facility Permit Act.pdf

Well Water Program1 document

  • Well Permit.pdf
    document Header Well Permit.pdf

Job Application1 document

  • Whiteside Application for Employment
    document Header Whiteside Application for Employment

Press Releases15 documents

  • 2022.10.27 Whiteside County Environmental Office Moves to Rock Falls Location
    document Header 2022.10.27 Whiteside County Environmental Office Moves to Rock Falls Location
  • 2022.10.26 IDPH News Release Halloween
    document Header 2022.10.26 IDPH News Release Halloween
  • 2022.09.23 WCHD Influenza Vaccine Available Today
    document Header 2022.09.23 WCHD Influenza Vaccine Available Today
  • 2022.09.19 WCHD High Dose Influenza Vaccine Available 9_20_22
    document Header 2022.09.19 WCHD High Dose Influenza Vaccine Available 9_20_22
  • 2022.09.12 WCHD to Begin Offering Bivalent Boosters.pdf
    document Header 2022.09.12 WCHD to Begin Offering Bivalent Boosters.pdf
  • 2022.09.01 Bivalent COVID-19 Updated Booster Approved
    document Header 2022.09.01 Bivalent COVID-19 Updated Booster Approved
  • 2022.08.25 First MPV Case in Dekalb County
    document Header 2022.08.25 First MPV Case in Dekalb County
  • 2022.08.09 First Case of MPV in Winnebago County
    document Header 2022.08.09 First Case of MPV in Winnebago County
  • 2022.08.05 Mosquitoes Test Positive for West Nile Virus Near Sterling IL
    document Header 2022.08.05 Mosquitoes Test Positive for West Nile Virus Near Sterling IL
  • 2022.08.03 MPV Vaccine Not Yet Available in Whiteside County
    document Header 2022.08.03 MPV Vaccine Not Yet Available in Whiteside County
  • 2022.07.01 WCHD SHIELD Community Testing Reopens July 6th
    document Header 2022.07.01 WCHD SHIELD Community Testing Reopens July 6th
  • 2022.06.29 WCHD SHIELD Testing Paused
    document Header 2022.06.29 WCHD SHIELD Testing Paused
  • 2022.06.02 First Probable Case of MPV in Illinois
    document Header 2022.06.02 First Probable Case of MPV in Illinois
  • 2022.05.23 COVID-19 Automated Case Notification Begins June 1
    document Header 2022.05.23 COVID-19 Automated Case Notification Begins June 1
  • 2022.02.25 WCHD No Appointment Required SHIELD Testing
    document Header 2022.02.25 WCHD No Appointment Required SHIELD Testing

Private Sewage Program7 documents

  • Residential Sewage System Permit Application.pdf
    document Header Residential Sewage System Permit Application.pdf
  • Qualified soil investigation services.pdf
    document Header Qualified soil investigation services.pdf
  • Non-residential Sewage System Permit Application.pdf
    document Header Non-residential Sewage System Permit Application.pdf
    Commercial Sewage System Permit Application
  • Installer Application.pdf
    document Header Installer Application.pdf
    Individual residential
  • Corporate Installer Application.pdf
    document Header Corporate Installer Application.pdf
    Corporate private sewage system installer application
  • Cleaner Application.pdf
    document Header Cleaner Application.pdf
    pumper application
  • Cleaner application Corporate.pdf
    document Header Cleaner application Corporate.pdf
    Corporate pumper application

Training1 document

  • Our Inspection Process.pdf
    document Header Our Inspection Process.pdf