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New Hampshire Department of Environmental Services
PUBLIC GOVERNMENT BUSINESS A to Z LIST

Report of Illness Form

If you or someone in your family becomes ill or develops a rash after recreating at one of New Hampshire’s public beaches, you should consult with your doctor and notify Beach Program personnel (see contact information below).

Use NH Online Forms to submit an illness report for a person or pet. Go to https://forms.nh.gov/onlineforms and sign in or register (if a first time user). After you have signed in, navigate to the form or go to https://forms.nh.gov/onlineforms/?FormTag=NHDES-W-07-026. Thank you for helping the Beach Program in tracking waterborne related illnesses throughout the state.

Sonya Carlson, Public Beach Program Coordinator
NH Department of Environmental Services
29 Hazen Drive; PO Box 95
Concord, NH 03302-0095
(603) 271-0698
(603) 271-7894 (fax)
[email protected]
[email protected]

 

 

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NH Department of Environmental Services | 29 Hazen Drive | PO Box 95 | Concord, NH 03302-0095
(603) 271-3503 | TDD Access: Relay NH 1-800-735-2964 | Hours: M-F, 8am-4pm

copyright 2016. State of New Hampshire