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Files and Forms
Up one levelPortsmouth City Health Department Files and Forms.
- Family Planning Clinic.pdf
- Financial Information Form.pdf
- History Form.pdf
- Male Physical Evaluation History.pdf
- Patient Billing Information.pdf
- Pregnancy Testing Form.pdf
- Privacy Practices.pdf
- Receipt of notice of privacy practices.pdf
- Sanitation Collection Information.pdf
- No Smoking Sign
- (8.5 x 11 inches) Please note: If the no smoking symbol is used, it must, in accordance with ORC 3794.06A be printed in color.
- H1N1 Influenza Basic Information
- SCIOTO COUNTY AND PORTSMOUTH CITY HEALTH DEPARTMENTS H1N1 BASIC INFORMATION