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    Vital Statistics

    • Birth and Death Certificates

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    • Restaurant Inspection Records
    • Food Safety Program
    • Sewage Treatment Systems
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    • Real Estate Inspections
    • Wells-Private Water Systems
    • Animal Bites - Rabies
    • Indoor Air
    • Pools and Spas
    • Mosquito Control
    • Plumbing
    • Solid Waste
    • Body Art

    Emergency Preparedness

    • Public Health Emergencies
    • Medical Reserve Corps

    Nursing

    • Public Health Nursing
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    • Communicable Disease Control
    • TB Control

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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



WIC PROGRAM APPLICATION + HEALTH HISTORY FORMS

  • 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  RS, MS, MBA
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
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Fairfield County Health Department
1550 Sheridan Drive, Suite 100
Lancaster, Ohio 43130
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