Feedback Form

Website Feedback

Submit general feedback so we can continuously improve the VDH site. Please do not include sensitive or personal identifying information. This includes: date of birth, test result, address and medical record number. Birth, Death and Marriage Certificate questions can be directed to the Division of Vital Records. Restaurant concerns can be reported to your local health district.

  • Max. file size: 100 MB.
    You can provide a screenshot of the problem you are experiencing.
  • This field is for validation purposes and should be left unchanged.
Last Updated: September 17, 2018