Permit applications and other miscellaneous forms are now available online. You will need Adobe Reader™ to be able to view and print these forms.  If you do not have Adobe Acrobat Reader™ just click on the appropriate link below.

Environmental Health

• Directions When Applying for a Sewage Disposal Permit and/or Water Supply Permit
• Helpful Hints for Preparing a Site Plan
• Application and Instructions to Use an Existing Sewage Disposal System and/or Water Supply
• Application for Sewage Permit
• Well Construction Permit Application
• Township Verification of Parcels
• Request for Public Record
• Environmental Health Fees
• DEQ Testing Fee Schedule - Water Tests and Other Miscellaneous Tests

Food Service

• Food Establishment Plan Review Resources for Regulators

• Thermometer Calibration Guide

• Metal Stem Thermometer Calibration

• Temperature Monitoring Forms

• Risk Control Plan

• FDA Food Code

• Food Law of 2000

• Food Code Fact Sheets

• Second Food Service Sanitation Inspection Request--Schools

Temporary Food Service

• Temporary Food Service License Application
• Temporary Food Operations Checklist
• Fact Sheet - Employee Personal Hygiene
• Fact Sheet - Gloves

Personal Health Services

• Authorization to Release Medical Information
• Vaccine Information Statements
• Maternal Support Services Risk Screening Tool
• Infant Support Services Risk Screening Tool

Communicable Disease Program

• Weekly School Reporting Form
• Michigan Communicable Disease Rules

Family Planning Program

• Annual Patient History Form (complete this form if you HAVE been a patient of this clinic)
• Initial Female History Form (complete this form if you HAVE NOT been a patient of this clinic)
• Initial Male History Form (complete this form if you HAVE NOT been a patient of this clinic)

General

• Authorization to Release Medical Information
• Application for Employment
• Notice of Privacy Practices - HIPAA
• Patient Acknowledgement and Consent Form - HIPAA

Emergency Preparedness

• Modular Emergency Medical System Concept Document

Page Last Updated:  05/13/2010

Questions or Comments?  Please e-mail to Webmaster
Website Maintained by:  Carol A. Stephens, MIS Manager
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