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CONTACT US
Fairfield Department
of Health
1550 Sheridan Drive
Suite 100 (map)
Lancaster, Ohio 43130
P: 740-652-2800
QUICK LINKS
Hours & Directions
2016 Annual Report
Board of Health
Contact Us
Forms
Resources
PHAB Accreditation
Spring Newsletter
ENVIRONMENTAL HEALTH FORMS
Nuisance Complaint Form
Food Facility Review Packet
Temporary Food Application Packet
Mobile Food Application Packet
Animal Bite Reporting Form
Plumbing Forms
Sewage Treatment Permit Application
Variance Request Form
Subdivision of Land / Lot Inspection Application
Private Water System Application
Well Pump Completion Form
As-Built Packet
Tattoo/ Body Piercing Facility Application
STS Abandonment Form

NURSING FORMS
TDAP & Menigitis Registration Forms for 7th & 12 grade
ODH Reportable Disease Form
ABC's of Reportable Diseases

WIC PROGRAM APPLICATION + HEALTH HISTORY FORMS :
WIC Program Application /
   History Forms: Pregnant Woman, Breastfeeding & Postpartum Woman,
   Infants under 12 months, Children 1-5 years

SPANISH
WIC PROGRAM APPLICATION + HEALTH HISTORY FORMS :
Historial de Salud de WIC para Mujeres Embarazadas
Historial de Salud de WIC para Infantes
Historial de Salud de WIC para Niņos de 1 hasta 5 Aņos
Historial de Salud de WIC para Mujeres LactandoAmamantando y en Postparto

VITAL STATISTICS FORMS
Application for Birth or Death Certificates
FAIRFIELD DEPARTMENT OF HEALTH: DEPARTMENT FORMS
Fairfield County Health Department