Skip to form

County of Chester

313 W Market Street, West Chester, PA, 19380, US



reportable diseases/conditions in Chester CountyLyme Disease Report FormAnimal Bite Report FormInfluenza Report Form

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.


Signature Type

Type Draw Upload Custom
Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue


Additional Signatures Required