Skip to main content
Imperial County
Public Health Department
Menu
Home
About Us
News Media
Alerts and Recalls
Be Prepared
Get Involved
Report a Health Issue
Forms
Contact Us
How Do I...?
Apply for a food handler permit
Dispose of household hazardous waste
Request public records/information
Request a Pet License
Get a physical exam-sports, wellchild, travel, DMV, immigration, safety
Request counseling and testing for HIV-STDs
Apply for an EMT Certification
Request a certified birth or death certificate
Request copy of my medical record
Get a TB test
Sell food at a community event
Apply for a septic permit
Search
Follow us on Facebook
Like us on Twitter
Clinical and Health Services
Community Health Initiatives
Maternal Child & Adolescent Health
Be Prepared
Emergency Preparedness
Community Partnerships
Training and Exercises
Health Promotion
Wellness
Environmental Health
Healthy Lifestyles
Forms
Menu
Birth - Death - Health Records
Toggle birth - death - health records sub-pages
Birth Certificate Application
Death Certificate Application
Release of Health Information
Immunization Record Request
Coalitions
Disease Report Forms
Toggle disease report forms sub-pages
Animal Bite Report
Confidential Morbidity Report
Enhanced Gonorrhea Surveillance
HIV - AIDS
Emergency Medical Services
Toggle emergency medical services sub-pages
AEMT Certification-Recertification
AEMT - EMT Livescan Form
AEMT Skills
EMT Skills Competency Form
EMT Optional Skills Competency Form
Medical Reserve Corps Application & Oath Form
MICN Authorization Application Form
Paramedic Accreditation Application
Statement of Affiliation
Environmental Health
Toggle environmental health sub-pages
Foodborne Illnesses Complaint Form
Maternal Child Adolescent Health
Toggle maternal child adolescent health sub-pages
Home Visiting Program Referral Form
Public Record Request
Forms
/
Disease Report Forms
Disease Report Forms
These forms are used to report disease cases to the Imperial County Public Health Department. For more information, call (442) 265-1464 or send an email 24/7 to
phepireport@co.imperial.ca.us
Animal Bite Report
Confidential Morbidty Report
Enhanced Gonorrhea
HIV- AIDS