Illinois Adoption Registry and Medical Information Exchange (IARMIE) Medical Questionnaire (VR 161.9 / IL482-1018)
Official state formAdoptionForm VR 161.9 / IL482-1018Free downloadLast verified November 10, 2026
Family medical history questionnaire, without identifying details, that is exchanged through the Illinois adoption registry. It is filed with the IARMIE registration at the Division of Vital Records. Filing it waives the $15 registration fee.
Who can use this form
- People who register with the Illinois Adoption Registry and Medical Information Exchange.
- It can be filed in place of the $15 registration fee.
What to send with it
- This questionnaire, filed with the IARMIE Application and the other registration forms.
- The Information Exchange Authorization form sets who may receive it.
Where to send it
- Mail to
- Illinois Department of Public Health Division of Vital Records 110 West Lawrence Ave. Springfield, Illinois 62704
- State fee
- No fee. Filing it waives the $15 registration fee.
- Typical processing
- Not provided
- Form revision
- rev. 08/26
- Source
- Official government page