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  • WIC PROGRAM
    • WIC: NUTRITIONAL
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  • ENVIRONMENTAL HEALTH
    • Food Protection / Education
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Fairfield Department of Health logo
Committed To Helping You Stay Healthy 
....... Serving Fairfield County Since 1893

The Fairfield Department of Health 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 
       History Forms: Pregnant Woman, Breastfeeding & Postpartum Woman,
       Infants under 12 months, Children 1-5 years

  • 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 UPDATE
As of Thursday, March 19, 2020, the Health Departent Building has been closed to the public. A list of numbers by divisions have been listed for information on how to conduct your business.
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
Larry Hanna
Administrator
larry.hanna@fairfieldcountyohio.gov
P: 740-652-2817
Amy Gabriel
Accreditation Coordinator
Administrative Assistant
CRI POD Manager
amy.gabriel@fairfieldcountyohio.gov
Fairfield Department of Health
1550 Sheridan Drive, Suite 100
Lancaster, Ohio 43130
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