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Members of the Public should utilize this form to request data
This form is used to apply for positions on Itasca County Committees/Commissions/Boards.
Public health intake form.
Access the Application for children's mental health respite grant.
Access the Children's Mental Health Intake form.
Please fill out an application for an appointment with the Itasca County Health and Human Services Advisory Committee.
Medical provider only completes this reimbursement form.
Access the request for restitution and affidavit form.
Access the Adult Mental Health Referral form.
Fill in the IMCare EFT (electronic funds transfer) and ERA (electronic remittance advice) authorization agreement