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    • Public Health
    • Childhood Immunization Clinics
    • Travel and Adult Immunization Clinics
    • Women, Infants & Children (WIC) Nutritional Services
    • Communicable Diseases
    • Bureau for Children with Medical Handicaps (BCMH)
    • CHA/CHIP
    • Tuberculosis Unit
  • WIC NUTRITIONAL
  • ENVIRONMENTAL HEALTH
    • Food Protection / Education
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    • Vector Control
    • Rabies + Animal Bites
    • Solid + Infectious Waste
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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.

TTY Services
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FAIRFIELD DEPARTMENT OF HEALTH: DEPARTMENT 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

QUICK LINKS
• Fee Schedule
• Hours & Directions
• 2017 Annual Report
• Forms
• PHAB Accreditation
• Continuous Quality
   Improvement Report

• Governing Rules/Regulations
• Mandated Programs
• Community Health
• Summer Newsletter
• FDH Strategic Plan
• FDH Brochure
CONTACT US
Phone:
740-652-2800
614-322-5245

Fax:
740-653-6626

Larry Hanna
Administrator
larry.hanna@fairfieldcountyohio.gov
P: 740-652-2817

Kathie Whitlock
Administrator Assistant
kathie.whitlock@fairfieldcountyohio.gov

PUBLIC RECORDS REQUEST
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Fairfield Department of Health
1550 Sheridan Drive, Suite 100 (map)
Lancaster, Ohio 43130

OFFICE + CLINIC HOURS
Monday-Friday 8am to 4pm
Note: Closed daily from 11:30am to 12:00pm

VITAL STATISTICS
Monday-Friday 8am to 4pm
Same-day service ends at 3:45pm
CONTACT US
740-652-2800 / 614-322-5245
Fax: 740-653-6626
Larry Hanna
Administrator
larry.hanna@fairfieldcountyohio.gov
P: 740-652-2817

Kathie Whitlock
Administrator Assistant
kathie.whitlock@fairfieldcountyohio.gov
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QUICK LINKS
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• Emergency Preparedness
• Hours & Directions
• 2017 Annual Report
• Community Health Assessment
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• Contact Us
• Forms
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• PHAB Accreditation
• Summer 2018 Newsletter
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