Form Center Module

Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

▼GIS

  1. New Address Application

    Application for a new rural building address.

▼Public Health Division

  1. Business Recognition Program Nomination Form

    Business Recognition Program Nomination Form

  2. COVID-19 Compliance Concerns

    Mask Mandate Compliance Concern

  3. Formulario de Registración de Vacuna COVID-19

    COVID-19 Vaccine Registration

  4. Licensed Establishment Complaints

    To file a complaint about a licensed establishment.

  5. Public Health Referral Form
  1. Community Vaccine Clinic Inquiry

    Please use this form if your organization is interested in a COVID-19 vaccination clinic.

  2. COVID-19 Test Results Request

    COVID-19 Test Results Request

  3. Human Health Hazards & Housing Concerns

    To file a complaint about a health hazard.

  4. Public Health Community Education Sessions

    Community Education Sessions are a fun, free, and interactive way for schools, business, and community organizations in Walworth County... More…

▼Public Works

  1. Adopt-A-Highway Clean Up

    Adopt - A - Highway clean up form