Forms

Environmental Health Forms

  1. Closed Loop Well Application (PDF)
  2. Closed Loop Well Completion Report (PDF)
  3. Freedom of Information Request Form (PDF)
  4. Request for Water Well Sealing Approval (PDF)
  5. Seasonal Portable Sanitation Application (PDF)
  6. Septic Permit Application (PDF)
  7. Single Event Portable Sanitation Application (PDF)
  8. Tri-County Green Hero Nomination Form
  9. Well Permit Application
  10. Operational Inspector Inspection Report

Community Health Forms

  1. Parent Handbook 22

CLINIC

  1. IESA IHSA Pre-participation Examination(Sports Physical)
  2. DOT Physical Form-Driver Section-complete and bring printed copy to appointment
  3. TCHD General Consent for Clinic Services
  4. Consent for Minor to Receive Clinical Services