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New Hampshire Department of Environmental Services

Report of Illness Form

If you or someone in your family (including pets!) becomes ill or develops a rash after recreating at one of New Hampshire's public beaches, you should first consult with your doctor and then notify Beach Program personnel via the contact information below.

For data tracking purposes, you may use NH Online Forms to submit a more detailed illness report for a person or pet. You can use this form without signing in (submit as guest user) or you can create an account. This form helps the Beach Program track where illnesses occur and various details about the illness such as length, symptoms, water contact, etc. The form data will also be given to the Department of Health and Human Services and may be shared with other agencies tracking waterborne illnesses. Thank you for helping to track waterborne related illnesses throughout the state.

Amanda McQuaid, Public Beach Program Coordinator
NH Department of Environmental Services
29 Hazen Drive; PO Box 95
Concord, NH 03302-0095
(603) 271-0698
(603) 271-7894 (fax)



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NH Department of Environmental Services | 29 Hazen Drive | PO Box 95 | Concord, NH 03302-0095
(603) 271-3503 | TDD Access: Relay NH 1-800-735-2964 | Hours: M-F, 8am-4pm

copyright 2017. State of New Hampshire