Birth and Death
Behavioral Risk Factor Surveillance System (BRFSS)
BRFSS Questionnaires
Certificate of Need
- Certificate of Need Application [PDF]
- Certificate of Need Laws / Regulations [PDF]
- State Health Plan [PDF]
College Student Internship
- Course Credit Application [PDF]
- Internship Application [PDF]
- Recommendation Form [PDF]
DC 30/J-1 Waiver Program
- DC 30/J-1 Visa Waiver Program Guidelines [PDF]
- DC Hospitals [PDF]
- DC Federal Qualified Health Centers [PDF]
- DC 30/J-1 Visa Waiver Application Guidelines and Checklist [PDF]
- End-of-Year Verification Form [PDF]
- Mid-Year Service [PDF]
Domestic Partnership
- Domestic Partnership Registration Form [PDF]
- Instructions [PDF]
- Affidavit of Mutual Residence [PDF]
- Request for Declaration [PDF]
- Additions or Corrections to Record [PDF]
- Withdrawal of Domestic Partnership Termination [PDF]
- Notice of Termination of Domestic Partnership [PDF]
Emergency Medical Services
Healthcare Facilities
- Assisted Living Residencies Renewal Application Instructions [PDF]
- Child Placing Agencies Application Package
- Community Residence Facilities - Application Package
- Group Homes for Persons with Intellectual Disabilities Application Package
- Home Care Agencies Application Package
- Intermediate Care Facilities For Persons with Intellectual Disabilities Application Package
Health Professionals - Licensing
- Professional License Application and Renewal
- Check Application Status
- Update License Information
- Online Professional License Search
- License Verification
Health Professionals - Loan Repayment
Hepatitis
HIV/AIDS
- HAHSTA Case Report Form for HIV/AIDS, viral hepatitis, and STDs
- DC ADAP Application Form [PDF]
- Condom Ordering Form (for DC Businesses)
- Condom Ordering Form (for Individual DC Residents)
- Categorical Budget Format [Excel]
Infectious Diseases Reporting
- HAHSTA Case Report Form for HIV/AIDS, viral hepatitis, and STDs
- Zika Virus Test Request and Reporting Form
- Communicable Disease Case Report Form
- Notifiable Disease and Pregnancy Report Form
- TB Case Report Form [PDF]
Institutional Review Board for the Public Health
- Exempt Review- Application Form [PDF] / Procedures for Submission [PDF]
- Full Review – Application Form [PDF]/ Procedures for Submission [PDF]
- Request for Use of Data with Identifiers & Statement of Assurances [PDF]
- Renewal/Continuation- Application Form [PDF]
School Health
- DC Oral Health Assessment Form
- HPV Opt-Out NB
- DC Universal Health Certificate
- Medication and Treatment Authorization Form
- Immunization Requirements
Sexually Transmitted Diseases
Tuberculosis
- TB Case Report Form [PDF]
Vital Records
- Birth Certificate Application Form [PDF]
- Death Certificate Application Form [PDF]
- Domestic Partnership
Zika