Attention: This form is for Chemung County residents only. If you are not a resident of Chemung County please contact your county health department.
Attention: You must validate your email address before submitting the form. Enter your email in the box above and click "Verify Email". Follow the instructions on the screen and then in the email to complete the form.
Attention: If you wish to request more than one type of document you must complete a request for each document.
Unfortunately, the County Health Department cannot issue any paperwork until an intake interview is completed by a case investigator. Due to an enormous increase in COVID-19 cases we are currently experiencing a backlog in performing case investigations.
We appreciate your understanding as we work through this matter.