Forms

  1. Environmental Health Forms

    Download forms, lists, and miscellaneous documents available from the Health Department.

    1. Complaint Form

    2. Document Request

    3. Food Service Application

      Michigan Department of Agriculture and Rural Development Food Service License Application

    4. Temporary Food Service License Application

      Application for a temporary food service

    5. Well and/or Septic Application

      Application needed for NEW or REPLACEMENT well or septic

  2. Personal Health

    Documents available on the website relating to Personal Health programs.

    1. Animal Bite Reporting Form

      Form for reporting an animal bite to the Lenawee County Health Department

    2. Authorization for Immunization of Minors

    3. Pediatric Immunization Registration Form

      Registration form for pediatric immunizations

    4. Release of Medical Records

      Release of medical records

    5. Request for Michigan Immunization Record

      Request for Official State of Michigan Immunization Record