1952 results found

Consultation Request

Thank you for your interest.  Please fill out the form below and a member of our team will be in touch to provide more information and assist you. We look forward to connecting with you! …

New/Replacement Clinical Product & Equipment Request Form

Please complete the form fields below. Date Please input in MM/DD/YEAR format. Required. Requester Required. …

DAISY Award Nominations

Want to thank your nurse for extraordinary care? Nominate a Blessing Health nurse for a DAISY award! DAISY awards honor those who personify Blessing Hospital and Illini Community Hospital's remarkable patient experience. These nurses…

Early Learning Center Scheduling Form

Please fill out this form as completely as you can. Schedules are due by 5pm on the scheduling deadline . A $10 late fee per child will be added for forms not turned in by the deadline. To submit a schedule for a currently enrolled child…

Air Evac Membership

Please complete the form below.  Name Phone Number Address Address Address 2 …

BHS Sponsorship Request Form

All sponsorship requests for consideration by Blessing Health System must be submitted using the online form below or in writing using the printable form a minimum of 30 days prior to the event.  The form can be completed and mailed…

Blessing Hospice & Palliative Care Volunteer Service Application

Please use the form below to apply to be a Blessing Hospice volunteer. If you prefer to print and mail in your application, please use this print-friendly application. Volunteers must complete the volunteer training program, pass a…

Application for Volunteer Service

If you are interested in sharing your time and talents as a Blessing volunteer, please complete this application, or call the Volunteer Services department at (217) 223-8400, ext. 6820. If you prefer to print and mail in your application,…

Work Life Business Application

Please submit your product, service or program for consideration in the Blessing Health System Work Life Services Program. All discounts offered will apply to all Blessing Health System employees which includes:  Blessing Corporate…

Quality Data Feedback Form

Please complete the fields below.  Was this information helpful? Yes No Questions about…