Nursing/Clinic Forms

Administrative

Public Participation Form (Submit form to one of these options  email: stephanie.bragg@morrowcountyhealth.org, fax: 419-946-6807 or bring form into office)

Public Participation Policy

Public Records Policy

Public Records Request

Blank IRS W-9 Form

Morrow County Health District W-9 Form

Vital Records
Birth/Death Certificate Application
Proof of Relationship Verification Form
Clinic Forms
Registration Consent
Flu
Privacy Practice Acknowledgement
Screening and Consent
Prior Authorization 
School Vaccine Clinic Consent Form

Environmental Health

Food

FSO/RFE License for Food Service Application

Mobile Food License Application

Temporary Food License Application

Food Service Operation/Retail Food Establishment Plan Review Application

Nuisance Complaints

Nuisance Complaint Form

Sewage

Lot Split Application Form
NPA/RPC Lot Split/Subdivision Review Checklist
New Build Process Form
Site Review Form
Soil Scientists
System Designers
Septic Permit
Registered Sewage Sys. Inspectors
Registered Sewage System Installers
Registered Sewage System Pumpers
Sewage Treatment Systems (STS) & COVID-19 Fact Sheet

Plumbing

2021 License Bond
Plumber Application
Registered Plumbers

Parks and Campground
Campground Application
Resident Camp Application
Temporary Camp Application
Swimming Pools and Beaches
Beach Application
Swimming Pool Application
Pool Plan Review Application
Water
Water Sample
Well Permit
Job Status Completion Form
Registered Service Provider

Contact Information
STS Contractor Fact Sheet
Service Provider Application
Service Provider Bond Form
Sewage System Non-Mechanical Inspection Form
Sewage System Aeration Inspection Form

Registered Hauler

Contact Information
STS Contractor Fact Sheet
Hauler Application
Hauler Bond Form

Registered Installer

Contact Information
STS Contractor Fact Sheet
Installer Application
Installer Bond Multi-System Form
As-Built Form

Miscellaneous

Variance Application
Animal Exposure Form

Accessibility