• COVID
    • Schedule My Vaccine
    • COVID-19 Report
    • COVID-19 Updates
  • NURSING
    • Public Health
    • Childhood Immunization Clinics
    • Travel and Adult Immunization Clinics
    • Communicable Diseases
    • Bureau for Children with Medical Handicaps (BCMH)
    • Tuberculosis Unit
    • Guidance for Providers
  • WIC PROGRAM
    • WIC: NUTRITIONAL
    • WIC: SNAP ED
  • ENVIRONMENTAL HEALTH
    • Food Protection / Education
    • Public Pools
    • Indoor Air Quality
    • Vector Control
    • Rabies + Animal Bites
    • Solid + Infectious Waste
    • Licensed Tattoo Facilities
    • Plumbing Program + Permits
    • Sewage Treatment Programs
    • Real Estate Inspections
    • Lot Splits + Subdivisions of Land
    • Private Water Systems
    • Staff of the Division of Environmental Health
    • Inspection Reports
  • BIRTH/DEATH
  • PLANNING & PREPAREDNESS
    • Emergency Preparedness Resources
    • Medical Reserve Corps
    • Community Health Assessment
  • CONTACTS / FORMS
    • Staff + Department Contacts
    • Board of Health
    • Location + Directions
    • Employment Opportunities
    • Public Records Request
    • Department Forms
    • Continuous Quality Improvement Report
    • Mandated Programs
    • Governing Rules/Regulations
    • Annual Report
    • Fee Schedule
    • Newsletter
    • PHAB Accreditation
    • Resources + Links
    • Strategic Plan
  • COVID
    • Schedule My Vaccine
    • COVID-19 Report
    • COVID-19 K-12 School Guidance
  • NURSING
    • Public Health
    • Childhood Immunization Clinics
    • Travel and Adult Immunization Clinics
    • Communicable Diseases
    • Bureau for Children with Medical Handicaps (BCMH)
    • Tuberculosis Unit
    • Guidance for Providers
  • WIC
    • WIC: NUTRITIONAL
    • WIC: SNAP ED
  • ENVIRONMENTAL HEALTH
    • Food Protection / Education
    • Public Pools
    • Indoor Air Quality
    • Vector Control
    • Rabies + Animal Bites
    • Solid + Infectious Waste
    • Licensed Tattoo Facilities
    • Plumbing Program + Permits
    • Sewage Treatment Programs
    • Real Estate Inspections
    • Lot Splits + Subdivisions of Land
    • Private Water Systems
    • Staff of the Division of Environmental Health
    • Inspection Reports
  • BIRTH/DEATH
  • PLANNING & PREPAREDNESS
    • Emergency Preparedness Resources
    • Medical Reserve Corps
    • Community Health Assessment
  • CONTACTS/FORMS
    • Staff + Department Contacts
    • Board of Health
    • Location + Directions
    • Employment Opportunities
    • Public Records Request
    • Department Forms
    • Continuous Quality Improvement Report
    • Mandated Programs
    • Governing Rules/Regulations
    • Annual Report
    • Fee Schedule
    • Newsletter
    • PHAB Accreditation
    • Resources + Links
    • Strategic Plan
Fairfield County Health Department logo
Committed To Helping You Stay Healthy 
....... Serving Fairfield County Since 1893

The Fairfield County Health Department is committed to serving the Fairfield County community by preventing disease, protecting the environment, and promoting healthy lifestyles.

FORMS

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
  • Adult Travel Paperwork  / Child Travel Paperwork
  • Immunization Clinic Form



WIC PROGRAM APPLICATION + HEALTH HISTORY FORMS

  • Welcome to WIC
  • WIC Program Application 
  • WIC Authorized Letter



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 Niños de 1 hasta 5 Años
  • Historial de Salud de WIC para Mujeres LactandoAmamantando y en Postparto

 

VITAL STATISTICS FORMS

Application for Birth or Death Certificates

DEPARTMENT HOURS
Monday-Friday 8:00am to 4:00pm
Closed for lunch 11:30am-12:00pm
Closed Saturday & Sunday
VITAL STATISTICS
Birth & Death Records
Phone: 740-652-2836
ENVIRONMENTAL SERVICES
Phone: 740-652-2813
W.I.C. SERVICES
will continue but will be limited
Phone: 740-652-2800
option #7 for appointments.
FOR ALL OTHER QUESTIONS
Phone: 740-652-2800
Phone: 614-322-5245
TTY Services
R. Joseph Ebel  RS, MS, MBA
Health Commissioner
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Fairfield County Health Department
1550 Sheridan Drive, Suite 100
Lancaster, Ohio 43130
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