VDH State Forms

• Permits and Design Forms

Please see the Documents, Forms & Downloads page on the Office of Emergency Medical Services website.

Bedding and Upholstery Inspection

• Bedding & Upholstered Furniture Forms

Division of Food and General Environmental Services

• Application for VDH Permit (unavailable)
• Application to Process or Distribute Grade A Milk (unavailable)

Division of Sewage and Water Services

• Alternative Discharging Sewage Treatment Regulations - 12 VAC 5-640-10 et seq. : Effective Date July 30, 1992 (unavailable)
• Combined (DEQ-VDH) Application for a Discharging System Permit
• Completion Statement (For Contractors Installing Systems)
• AOSE Regulations - 12 VAC 5-615-10 et seq. : Effective July 1, 2002 (unavailable)
• AOSE Application (unavailable)
• AOSE Renewal Application (unavailable)
• AOSE Reference
• Soil Evalution
• Soil Profile Description
• Sewage Disposal System Construction Specifications
• Soils Evaluation Percolation Test Data
• Completion Statement (For Contractors Installing Systems)
• Fee Regulations - 12 VAC 5-620-10 et.seq. : Effective Date July 1st, 1989
• Private Well Regulations - 12 VAC 5-630-10 et seq. : Effective Date April 1, 1992
• Application for a Well Construction Permit
• Uniform Well Completion Report
• Sewage Collection and Treatment (SCAT) Regulations
• Sewage Handling and Disposal Regulations - 12 VAC 5-610-10 et seq. : Effective July 1st, 2000
• Application for a Sewage Disposal System Construction Permit
• Application for Sewage Handling Permit
• Application for Pump and Haul Storage Facility Construction Permit
• Physiographic Map of Virginia
• Field Guide to Soil Textures (Appendix F)
• Percorlation Test Procedure (Appendix G)
• Soils Evaluation Percorlation Test Data
• Completion Statement

• Morbidity Reporting Form (Epi-1, Revised 2011)

Division of Immunization

• School Requirements Forms
• Virginia Vaccines for Children
• Perinatal Hepatitis B Prevention Forms

Division of Disease Prevention (DDP)

• DDP Health Professionals Page: Updates, guidelines, and resources for healthcare providers related to HIV, STDs, and viral hepatitis
• DDP Community Partners Page: Updates, guidelines, resources, and forms for community partners and funded agencies.  Includes items such as contractor guidelines, condom order forms, the Monthly Request for Payment Template, and more.
• DDP Communications Resources Page: Monthly division newsletters and agency and national resources for HIV, STDs, and viral hepatitis.
• Resource Connections: Service directory HIV, STD, viral hepatitis, and other related services in Virginia.  Local health departments/districts are listed in the directory. (Note that we will update this when the new link/URL is available)

Tuberculosis

• Forms for Local Health Departments
• Screening and Testing for TB
• LTBI Resources
• TB Disease Resources
• Virginia TB Law

Division of Dental Health

• School Fluoride Mouthrinse Supply Order Form

Division of Women, Infants and Children(WIC) and Community Nutrition Services

• WIC General Forms and Materials
• WIC Retail Store Management Forms and Materials