Request Documents & Forms

The following information and resources have been compiled to help our residents, elected officials, professional colleagues and our customers find the information and resources they need.  If you are unable to find the information you are looking for, please contact us and we will do our best to help.

Customer Service/Vital Statistics

• Birth/Death Record Request Form
• Freedom of Information Request Form
• Genealogy Research Request Form

Clinical Services

• Provider Referral for TB Services

Environmental Health & Food Safety

• Animal Bite Report Form
• Application for a Hotel/Motel Permit
• Application for a License to Conduct a Food Service Operation or Food Service Establishment
• Application for a License to Operate a Public Swimming Pool, Public Spa or Special Use Pool
• Application for a License to Operate a Recreational Vehicle Park, Recreation Camp or Combined Camp/Park
• Food Safety Course Application Registration
• Plan Review for Food Service Operations
• Temporary Food Service License, Guidelines & Application
• Rabies Test Form

Epidemiology and Assessment

• Communicable Disease Reporting Form

Plumbing

• Application for Permit to Install Plumbing
• Backflow Test Sheet
• Escrow Form
• Homeowner’s Plumbing Information and Agreement Form
• Medical Gas Application
• Medical Gas Testing Form
• Plumbing Bond Form
• Plumbing Contractor Registration Application
• Shower Liner Test
• Transfer Plumbing Permit

Waste Management

• Waste Hauler’s Registration Form

Water Quality

(Sewage Treatment Systems, Private Water Systems, and Storm Water)

• Abandoning an STS
• Application for STS Review for Property Improvements/Modifications
• Application to Construct/Replace a Household Sewage Treatment System
• Application/Permit for a Private Water System in Ohio
• Application – Subdivision Development Evaluation Packet
• Contractor Registration for HCPH
• Existing Lot Review
• Freedom of Information Act – Ohio Public Records Request Form
• Private Water Systems Contractor Well Inspection Report Form
• Real Estate Transfer Request Form
• Sewage Treatment System Contractor Registration Form
• Sewage Treatment System or Gray Water Recycling System Installation/Reinspection Fee
• STS Alteration Application
• STS Replacement Packet
• Water Sample Application Non-Chemical Analysis

Additional Resources

• Fact Sheets
• FOI Requests (form at the bottom of the page)
• Public Record Policy
• Reports