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Forms and General VDH Documents


CHS - 1A Consent for Health Care - V1   | English |


CHS - 1A Consent for Health Care - V2   | English |


CHS - 1B Consent for Special Health Services   | English |


CHS - 1C Application and Agreement for Payment Plan   | English |


Eligibility Form (Alexandria)   | English |


PPD/Tuberculosis Skin Testing /Informed Consent   | English |


Requirement of Proof (Thomas Jefferson)   | English |


VDH Confidential Health History '05 Part 1*   | English |


VDH Confidential HealthHistory '05 Part 2*   | English |


VDH STD Confidential Health History '05*   | English |


Welcome to VDH Leaflet   | English |


Chief Medical Examiner


Information for Family & Friends Brochure   | English |


Emergency Medical Services


PPCR Patient Refusal   | English |


Emergency Preparedness and Response


Anthrax Fact Sheet   | English |


Botulism Fact Sheet   | English |


Brucellosis Fact Sheet   | English |


Chemical Blister Agents   | English |


Chemical Chlorine Agents   | English |


Chemical Nerve Agents   | English |


Dirty Bomb   | English |


Nuclear Bomb   | English |


Nuclear Power Plant Accident   | English |


Pandemic Flu   | English |


Plague   | English |


Public Health Emergency Wallet Card   | English |


Recin Toxins   | English |


Small Pox Disease Fact Sheet   | English |


Small Pox Vaccine Fact Sheet   | English |


Tularemia   | English |


Unknown Chemical Exposure   | English |


Viral Hemorrhagic Fever   | English |


Epidemiology

General | Immunization | Sexually Transmitted Diseases |
Zoonotic and Environmental Epidemiology


General


Acanthamoeba (prepared by the U.S. Food & Drug Administration)
English


AIDS Drug Assistance Program (ADAP) brochure
English | Spanish


Amebiasis Fact Sheet   | English |


Antibiotic Resistance   | English |


Arboviral Infection   | English |


Aseptic Meningitis (a.k.a., Viral Meningitis)  | English |


Campylobacteriosis Fact Sheet   | English |


Chancroid   | English |


Chicken Pox   | English |


Cholera Fact Sheet   | English |


Congenital Rubella Syndrome   | English |


Cryptosporidiosis   | English |


Crptosporidiosis and Additional Prevention Information   | English |


Cryptosporidiosis and Drinking Water   | English |


Diphteria Fact Sheet   | English |


E. Coli 0157:h7   | English |


Encephalitis   | English |


Erlichiosis   | English |


Giardiasis   | English |


Granuloma Inguinal   | English |


Haemophilus Influenzae Type B   | English |


Hepatitis B   | English |


Hepatitis C   | English |


High Levels of Lead in a Child's Blood   | English |


Histoplasmosis   | English |


HIV   | English |


Influenza   | English |


Kawasaki Syndrome   | English |


Legionellosis  | English |


Leprosy  | English |


Leptospirosis   | English |


Listeriosis  | English |


Lyme Disease   | English |


Lymphogranuloma Venereum   | English |


Malaria   | English |


Measles   | English |


Meningococcal Infection   | English |


Mumps   | English |


National HIV Testing Day   | English |


Pediculosis   | English |


Pertussis   | English |


Polio   | English |


Psittacosis   | English |


Rocky Mountain Spotted Fever   | English |


Rubella   | English |


Salmonellosis   | English |


Shingellosis   | English |


Streptococcal Disease   | English |


Tetanus (Lockjaw)   | English |


Trichinosis   | English |


Typhoid Fever   | English |


Typhus Fever
   Epidemic Typhus Fever (louse-bourne)  | English |
   Endemic Typhus Fever (flea-bourne)  | English |
   Scrub Typhus Fever (mite-bourne)  | English |


Viral Hemorrhagic Fever   | English |


Immunization


Spanish Videotapes Available for Loan from VDH, Division of Immunization   | English |


Sexually Transmitted Diseases


Brochures for Order - These brochures are available in the languages below. Pictures are not available for all. Most of the brochures can be ordered here.

Abstinence - Saying "NO" to Sex   | English |

ADAP: Information for Parents   | English |

Anyone Can get HIV AIDS   | English |

Genital Warts and HPV - What You Need to Know   | English |

Hepatitis C - What You Should Know   | English |

HIV Anitbody Testing   | English |

HIV - Women Get It Too!   | English |

How to Use a Condom (Rubber)   | English |

It's Your Body Respect It Protect It!   | English |

Notice of "Deemed Consent" for HIV, HBV, and HCV Testing   | English |

Sexually Transmitted Diseases   | English |

So You Think Chlamydia is a Flower!   | English |

What About This Disease Called Chlamydia   | English |

Young People Get HIV   | English |

You, Your Baby and HIV   | English |


Brochures to Print (pdf open in adobe acrobat reader and can then be printed)

After the Test - Tuberculosis   | English |

Do I Need a TB Skin Test?   | English |

Information on Tuberculosis (I)   | English |

Information on Tuberculosis (II)   | English |

INH Fact Sheet   | English |

Just the Facts About BCG and TB   | English |

Stop TB Infection Before it Makes You Sick   | English |

TB and HIV: A Dangerous Partnership   | English |

TB Disease: Class 2   | English |

TB Disease: Class 3 and 5   | English |

TB Disease: You Need Treatment to Make You Well   | English |

What is a TB Skin Test?   | English |

What You Should Know About Taking Tuberculosis Medicines   | English |


Zoonotic and Environmental Epidemiology


Hantavirus brochure   | English |


Harmful Algal Blooms & Other Organisms of Concern in Coastal Waters   | English |


Pfiesteria   | English |


Rabies brochure   | English |


Tick Brochure   | English |


Safely Enjoying Virginia's Waters brochure   | English |


Family Health Services

Abstinence | Dental | Early Hearing Detection |
Every Woman's Life | Family Planning | Folic Acid | Genetics | Injury and Violence Prevention | Lead


Abstinence


Abstinence & Teen Pregnancy Posters   | English |


Dare to See Things Differently Poster   | English |


Fathers Make a Difference!   | English |


Helping Kids Say "No"   | English |


How to be an "Ask-able" Parent   | English |


Interconnections of Risk Behaviors   | English |


Mothers Influence on Daughter's Sexual Behaviors   | English |


Navigating Teen Years Helpful Tips for Parents   | English |


Pointers for Parents   | English |


Virginia Abstinence Education Initiative: Parents   | English |


What Are Kids Thinking These Days?   | English |


Dental


A Healthy Diet is Something to Smile About   | English |


Baby's First Step to Health Teeth   | English |


Don't Run Out of Time For a Healthy Smile   | English |


Oral Health: Self Exam for Oral Cancer   | English |


Seal Away Tooth Decay   | English |


Smile for Good Health   | English |


Swish Away Decay   | English |


Why Floss?   | English |


Early Hearing Detection


Information for Parents of Children with Hearing Loss, Virginia's Resource Guide for Parents   | English |


Virginia's Newborn Hearing Screening Program   | English |


Every Woman's Life


Every Woman's Life: Cervical/Breast Cancer Detection   | English |


Every Woman's Life: New Patient Fact Sheet   | English |


Family Planning*


ABC's About Sex   | English |


Birth Control Patch   | English |


Cycle Beads   | English |


Depo Provera   | English |


Emergency Contraceptive   | English |


IUD   | English |


Nuvaring - Inside brochure   | English |


Nuvaring - Outside brochure   | English |


Pelvic Exam   | English |


Vaginal Health Care   | English |


Folic Acid


Folic Acid: Now You're Talking Healthy!

Bookmark   | English |

Brochure   | English |

Poster   | English |

Storyboard  | English |


Genetics


Anencephaly   | English |


Cleft Lip and Cleft Palate   | English |


Club Foot   | English |


Congenital Heart Defects   | English |


Down Syndrome  | English |


Hypospadias   | English |


Screening Tests for Your Baby   | English |


Spina Bifida   | English |


Trisomey 13   | English |


Trisomy 18   | English |


Virginia Congenital Anomalies Reporting and Education System (VaCares)   | English |


What Every Family Should Know About Preventing Birth Defects   | English |


Injury and Violence Prevention


Avoiding Sexual Coercion   | English |


Bicycle and Skate

Safety   | English |

Brochure   | English |

Poster   | English |


Bullying Prevention   | English |


Child Passenger Safety   | English |


Choking and Strangulation Prevention   | English |


Domestic Violence Prevention   | English |


Drowning Prevention   | English |


Fall Prevention for Children   | English |


Fire and Fall Prevention for Older Adults   | English |


Fire Safety   | English |


Gun Safety   | English |


Inhalant Abuse Prevention   | English


Pedestrian & School Bus Safety   | English |


Playground Safety   | English |


Rape and Sexual Violence Prevention   | English |


Suicide Prevention   | English |


Sweet Dreams, Safe Sleep for Babies   | English |


Teen Dating Violence Prevention for Parents of Teens   | English |


Walk Smart, Virginia!

Brochure   | English |

Poster   | English |

Toolkit   | English |


Lead


Before Your Baby Begins to Walk, Learn About Lead Poisoning   | English |


Keep It Clean brochure   | English |


Lead Poisoning and Your Children   | English |


Protect Your Family From Lead in Your Home   | English |


Reducing Lead Hazards When Remodeling Your Home   | English |


Tenant Lead Hazard Disclosure Presentation   | English |


When You Moved Into This Building, Were You Told About Lead Hazards?   | English |


Vital Records


Application for Certification of a Vital Record   | English |


Women, Infants and Children Program


Family Planning Order Form - Publications are available in Spanish   | English |


Healthbites   | English |


Healthbites: After Delivery | English |

Healthbites: After Delivery - Fruits & Vegetables   | English |

Healthbites: After Delivery - Milk Matters   | English |


Healthbites: Babies   | English |

Healthbites: Babies - Breastfeeding  | English |

Healthbites: Babies - Solid Foods   | English |


Healthbites: Cookbook   | English |


Healthbites: Family

Bean Energy   | English |

Bean Heart   | English |

Bean Heart   | English |

Bean Production   | English |

Bean World   | English |

Fast Food   | English |

Food Safety   | English |

Lactose Intolerant   | English |

Meal Planning   | English |

Sodium   | English |


Healthbites: Preschoolers   | English |

Importance of Breakfast   | English |

Meal Time   | English |

Snacks   | English |

Too Much TV   | English |


Healthbites: Pregnancy   | English |

Healthy Snacks   | English |

Developmental Stages   | English |

Fruits & Vegetables  | English |

Milk is Important   | English |

Constipation   | English |

Iron  | English |


Healthbites: Toddlers    | English |

Milk   | English |

Fussy Eaters   | English |

Meal Hour   | English |

Play   | English |

Snacks   | English |

Utensils   | English |

Water   | English |


Healthbites: Resources   | English |


Other


Rappahannock Area Health District Food Services Procedures Documents and Forms   | English |


Virginia Hurricane Guide - Hampton Roads Region   | English |


*This document is only accessible by VDH employees


Last Updated: 04-28-2010

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