Local Health Department Forms, Documents and Administrative Reference

​​Administrative Reference 

Local Health Department Administrative Reference Document

Training Matrix

LHD Training List

DownloadLHD Document Types
DFS-215 Application for ReinstatementEnvironmental Health
DFS-222 Notice and Order of Quarantine/Voluntary DestructionEnvironmental Health
DFS-232 Permit to OperateEnvironmental Health
DFS-253 Ear Piercing Studio Inspection ReportEnvironmental Health
DFS-303 Application for Certification/RegistrationEnvironmental Health
DFS-306 Application for a Permit/License Environmental Health
DFS-308 Youth Camp Inspection ReportEnvironmental Health
DFS-309 Youth Camp Accident/Illness ReportEnvironmental Health
DFS-317 Application for a PermitEnvironmental Health
DFS-319 Onsite Sewage Disposal Systems Application for Site EvaluationEnvironmental Health
DFS-325 Request for Onsite Sewage Disposal System VarianceEnvironmental Health
DFS-326 Existing Sewage System and Owner's AffidavitEnvironmental Health
DFS-327 Request for Service RecordEnvironmental Health
DFS-334 Alternative/Experimental Onsite Sewage Disposal SystemEnvironmental Health
DFS-335 Business License Surety BondEnvironmental Health
DFS-336 Affidavit of Surety's QualificationsEnvironmental Health
DFS-340 Application and Permit to Operate Day Camp FacilitiesEnvironmental Health
DFS-345 Application for Site Evaluation and Permit to Operate a Disposal SiteEnvironmental Health
DFS-400 Tanning Facility Registration/MonitorEnvironmental Health
DFS-405 Onsite Sewage Agency Referral FormEnvironmental Health
Enviro Shelter Surveillance FormEnvironmental Health
LHO-001 PSRS/BRIDGE Security RequestLHD Security Request
LHO-002 CMS PORTAL Security RequestLHD Security Request
LHO-003 EHMIS/PORTAL Security RequestLHD Security Request
LHO-004 CDP eReports Security RequestLHD Security Request
LHO-005 L-Drive Security Request (LHDs only)LHD Security Request
LHO-006 Global Email Distribution Request FormLHD Security Request
LHO-007 Splash-BI Tool Security RequestLHD Security Request
WIC-001 CDP WIC eReports Security RequestLHD Security Request

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