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. Type of Feedback*WebsiteGeneral Question or CommentName (Optional) First Last EmailWebpage addressFeedbackFile UploadYou can provide a screenshot of the problem you are experiencing.CAPTCHANameThis field is for validation purposes and should be left unchanged.