UCHD, Protecting Your Health.

 

Forms

Links to all the forms that the Union County Health Department uses are found on this page.  You may print and fill out the forms before you come into the office to pay the appropriate fees.  If you have questions about the form, please call the health department at (937) 642-2053.  If you are unsure of which form to use, visit the appropriate web page or call the health department.

Simply filling out a form does not guarantee that you will receive the license or permit.  Filling out the form is just one step within the processes that must be taken. All forms are required to be filed with the health department before work begins.

Food

icon Temporary Food Application
icon Mobile Food Application
icon Restaurant/Retail Food Application
icon Facility Review Application
icon Employee Health Policy

 

Sewer and Water

 

 Well Permit Application (new wells, alterations, or well sealing) Editable electronic copy

 icon Well Permit and Completion Forms (new wells, alteration, or well sealing)  Third page is completion form.

Septic System Application (new installation or replacement) - Triplicate form must be obtained in the office.

 

Animal Bites

icon Animal Bite Report Form
icon Veterinarian Form

 

Records Request

icon Records Request

NOTICE: Per Ohio Sunshine Laws, records requests do NOT have to be made in writing; requests do NOT have to use specfic language; and requesters do NOT have to provide a name, contact information or reason for request. The form above will assist in fulfilling records requests. Requesters may choose to complete this form, or staff can take a verbal request and document it on this form. This form is not required to receive records from the Union County Health Department it is only an aid to our staff. 

 

Tattoos and Body Piercing

icon Tattoo Parlor Application

 

Manufactured Home Parks

icon Placement Form

 

Variance

icon Variance Request Form