Downloadable Forms
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We have organized these documents by the sections they appear. If you already have the Adobe Reader®, just click on the form below. Once you have downloaded the form, it can be printed out, filled in and mailed to the Farmington Valley Health District with any necessary fees.
Fee Schedule
2007 Fee Schedule
Adobe PDF 97k
These forms are in PDF format and require the freely available Adobe Reader®, click on the icon below to find out more about this file format and to download the reader.
Child Day Care
Poisonous Plants and Safe Plants
Adobe PDF 115kb
Potential Environmental Hazards in Day Care Facilities
Selecting an Appropriate Sanitizer
Adobe PDF 167kb
Shock Absorbing Materials
Adobe PDF 139kb
Emergency Preparedness
HAN Participation Form
Adobe PDF 179kb
Non-medical Volunteer Application
Adobe PDF 119kb
Medical Volunteer Application
Adobe PDF 129kb
Smallpox Vaccination Consent Form
Adobe PDF 90kb
Smallpox Vaccination Information Sheet
Adobe PDF 191kb
Smallpox: What to do after vaccination
Adobe PDF 89kb
Anthrax: Family or Household Screening and Dispensing Form
Adobe PDF 90kb
Anthrax: Individual Screening and Dispensing Form
Adobe PDF 129kb
Food Protection
Annual Food Service Permit Application
Adobe PDF 159kb
Annual Non-Profit Food Service Application
Adobe PDF 95kb
Food Service Regulations
Adobe PDF 224kb
Fee Schedule
Adobe PDF 109kb
Temporary Food Event Application
Adobe PDF 758kb
Temporary Event Sponsor Form
Adobe PDF 278kb
Qualified Food Operator Demonstrated Knowledge Statement
Adobe PDF 123kb
Designated Alternate Demonstrated Knowledge Statement
Adobe PDF 87kb
Food Service Plan Review Application
Adobe PDF 95kb
Food Service Plan Review Guidelines
Adobe PDF 381kb
Employee Training Record
Adobe PDF 103kb
Public Swimming Pools
Pool Regulations
Adobe PDF 158kb
CT Public Health Code
19-13-B33b
Adobe PDF 82kb
Pool Testing Log
Adobe PDF 71kb
Annual Pool Permit Application
Adobe PDF 104kb
Guidelines for Closure
Adobe PDF 163kb
Recommended Procedure for Cleanup of Fecal, Vomit and Blood Incidents
Adobe PDF 117kb
Swimming Pool Operator's Test
Adobe PDF 114kb
Wells and Water Testing
Septic
Location Approval Packet
Adobe PDF 261kb
Site Evalution: Information for Homeowners
Adobe PDF 252kb
Request for Soil Test Observation
Adobe PDF 121kb
Subdivision Application and Feasibility
Adobe PDF 72kb
Application for Approval of Plans
Adobe PDF 96kb
Subsurface Sewage Disposal Systems Regulations
Adobe PDF 143kb
Surface Water Testing Areas
Map of Surface Water Testing Areas
Adobe PDF 987kb