Forms
9
2
1
2
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Environmental Health Forms
Download forms, lists, and miscellaneous documents available from the Health Department.
- Complaint Form
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Document Request
Instructions for requesting information on a property in Lenawee County
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Temporary Food Service License Application
Application for a temporary food service
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Well and/or Septic Application
Application needed for NEW or REPLACEMENT well or septic
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STFU Intent to Operate Form
Notification form that STFUs must submit 4 days prior to operating in any particular location
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Personal Health
Documents available on the website relating to Personal Health programs.
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Animal Bite Reporting Form
Form for reporting an animal bite to the Lenawee County Health Department
- Authorization for Immunization of Minors
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Pediatric Immunization Registration Form
Registration form for pediatric immunizations
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Release of Medical Records
Release of medical records
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Request for Michigan Immunization Record
Request for Official State of Michigan Immunization Record
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Communicable Disease Reports Form for Healthcare Provider Use
Healthcare providers use this form to report communicable diseases to the Lenawee County Health Department.
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Animal Bite Reporting Form