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  • SEARCH A-Z
DOCUMENTS and FORMS LIBRARY
ADMINISTRATION
  • • Annual Report
ENVIRONMENTAL HEALTH
  • • 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
PUBLIC HEALTH NURSING
  • • TDAP & Menigitis Registration Forms for 7th & 12th grade
  • • ODH Reportable Disease Form
  • • ABC's of Reportable Diseases
WIC PROGRAM
  • • 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
R. Joseph Ebel, MS, MBA, REHS
Health Commissioner
DEPARTMENT HOURS
Monday-Friday 8:00am to 4:00pm
Closed Saturday & Sunday
FOR ALL OTHER QUESTIONS
Phone: 740-652-2800
Phone: 614-322-5245
TTY Services
VITAL STATISTICS
Birth & Death Records
Phone: 740-652-2836
ENVIRONMENTAL SERVICES
Phone: 740-652-2813
W.I.C. SERVICES
Phone: 740-652-2800
option #8 for appointments
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Fairfield County Health Department
1550 Sheridan Drive, Suite 100
Lancaster, Ohio 43130
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