Jefferson County
General Health District
Forms

Download and Print These Forms for Fast Service

Please check back for forms from the Jefferson County General Health District. If you have any questions or concerns, please call us at (740) 283-8530 or contact us online. View the following resources to learn more about our services:

NURSING SERVICES

Nursing Consent Form
Authorization to Release Records

ENVIRONMENTAL SERVICES

Food Service Operations for Businesses

Food Service Packet 2022
Temporary Food packet 2023
Vending Application
Serve It Safely Information Form
Mobile Food Service Handbook
Hand Wash Sign
RFE or FSO Application
Temporary Food Application
Mobile Food Application
Food Complaint Form

public health Nuisance & Animal bites

Animal Bite Report
Nuisance Complaint

PLUMBING

Plumbing Permit

SEWAGE TREATMENT SYSTEMS

Sewage As Built Drawing Form
Septic Abandonment Form
Permit to Install/Alter Household Treatment System

Point of Sale Application - Loan Evaluation

Point of Sale Application Loan Evaluation 2022

Water Testing

Request for Individual Onsite Water Supply 2022
Water Sampling Request

INTENT TO FILL

Notice Of Intent To Fill

Jefferson County General Health District Forms

Download and Print These Forms for Fast Service

Jefferson County
General Health District
Forms