Skip to Content
Visit FloridaHealth.gov
Duval County
Alachua County Baker County Bay County Bradford County Brevard County Broward County Calhoun County Charlotte County Citrus County Clay County Collier County Columbia County DeSoto County Dixie County Duval County Escambia County Flagler County Franklin County Gadsden County Gilchrist County Glades County Gulf County Hamilton County Hardee County Hendry County Hernando County Highlands County Hillsborough County Holmes County Indian River County Jackson County Jefferson County Lafayette County Lake County Lee County Leon County Levy County Liberty County Madison County Manatee County Marion County Martin County Miami-Dade County Monroe County Nassau County Okaloosa County Okeechobee County Orange County Osceola County Palm Beach County Pasco County Pinellas County Polk County Putnam County Santa Rosa County Sarasota County Seminole County St. Johns County St. Lucie County Sumter County Suwannee County Taylor County Union County Volusia County Wakulla County Walton County Washington County

  • About
  • Contact
  • Patient Portal
Florida Department of Health in Duval County logo
Florida Department of Health in Duval County
  • Programs & Services
  • Certificates
  • Locations
  • News
  • Events

Search the site

Advanced search tips
Advanced Search

Advanced search allows you to perform more precise searches using special operators:

Examples:
  • "health department" (Find exact phrase)
  • +health +services (Must contain both words)
  • health -dental (Contains health but not dental)
Popular searches:
Birth Certificates Renew a License Marriage License WIC
Filter by type:
Home / Programs & Services/ Clinical and Nutrition Services / Patient Forms

Patient Forms

  • Initiation of Services 
  • Method of Contact and Appointment Notification Requirements 
  • Self Financial Evaluation – English 
  • Self Financial Evaluation – Spanish 
  • Consent to Care by Professional In Training 

Programs & Services
  • Clinical and Nutrition Services
    • Behavioral Health
    • Breast and Cervical Health
    • Center for Specialized Pulmonary Services
    • Children's Health Services
    • Community Health Programs
      • Healthy Start
      • School Health
    • Dental
      • Mobile Dental Program
    • Eligibility Requirements
    • Family Planning Clinical Services
    • Healthcare Practitioner Disease Reporting
    • HIV Clinical Services
    • Immunizations
    • Patient Forms
    • Pharmacy Services
    • Refugee Health
    • STD Clinical Services
    • WIC Program
    • Women's Health

Florida Department of Health in Duval County

Phone: 904-253-1000
CHD16_DCHD_Contact@FLHealth.gov

Mailing Address
921 N. Davis St.
Building A, Suite 251
Jacksonville, FL 32209

Florida Department of Health logo
Led by the State Surgeon General, the mission of the Florida Department of Health is to protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts.
  • About Florida Health
    • About Us
    • Leadership
    • Careers with Florida Health
    • Contact Us
  • Resources
    • Public Records Requests
    • Public Meeting Notices
    • Public Notices
    • Boards, Councils, and Committees

Legal & Site Information

  • Accessibility
  • Accreditation
  • Disclaimer
  • Electronic Communication
  • Privacy Policy
  • Site Map
  • Visit us on Facebook
  • Visit us on Instagram
  • Visit us on Twitter
  • Visit us on YouTube

© Copyright 2026. Florida Department of Health. All Rights Reserved.

Florida Department of Health in Duval County logo