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Auglaize County Health Department

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  • Environmental Health Division
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  • Nursing Division
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  • Environmental Health Division
    • Animal Bites or Rabies
    • Body Art and Piercing
    • Campground Inspections
    • Food Safety
      • Restaurant and Retail Store Inspections
    • Harmful Algal Bloom
    • Household Sewage Treatment Systems
    • Manufactured Home Parks
    • Nuisance Complaints
    • Private Water Systems
    • Radon
    • School Inspections
    • Swimming Pool Inspections
  • Help Me Grow
    • Early Intervention
    • Home Visiting
    • Who Can Refer to Help Me Grow?
  • Nursing Division
    • Immunization Clinics
    • Women's Health Program
    • Bureau for Children with Medical Handicaps
    • Infectious Disease
      • Antibiotic Resistant Organisms
      • Foreign Travel
      • Head Lice
      • Norovirus
      • Infectious Disease Control Manual
    • Appointment Reminder Page
    • Sexual Transmitted Disease
    • Tuberculosis (TB) Skin Testing
  • Community Outreach
    • Community Health Assessment
    • Community Health Improvement Plan
  • Emergency Preparedness
    • Additional Emergency Preparedness Resources
    • Emergency Volunteers (AugCoMRC)
  • Vital Statistics
    • Birth Certificate
    • Death Certificate
    • Request a Birth/Death Certificate
  • WIC Program
    • Breastfeeding Support
    • New Appointment
    • Resources
    • Nutrition Education
Brochures

Forms

Commonly requested forms are available in the right hand column.

Resources

Forms & PDF's

PDF icon Birth/Death Certificate Application Form
PDF icon FSO/RFE Plan Review Guide
PDF icon Well Permit Application
PDF icon Animal Bite Reporting Form
PDF icon Lot Split Application
PDF icon Notice of Privacy Practices
PDF icon Sewage and/or Water Eval Form
PDF icon Temporary Food Service Application
PDF icon Parental Permission Form (Immunizations)
PDF icon TB Administration Form
PDF icon Pediatric Immunization Form
PDF icon Adult Immunization Form
PDF icon COVID VACCINE FORM
PDF icon FLU Immunization Form
  • About Us
  • Preparedness Planning
  • Environmental Division
  • Help Me Grow
  • Vital Statistics
  • WIC Program
  • Contact Us
  • Nursing Division
    • Immunization Clinics
    • Family Planning Clinic
    • Health Education
    • Bureau for Children with Medical Handicaps
    • Communicable Diseases
    • Sexual Transmitted Diseases

Address

813 Defiance Street
Wapakoneta, OH 45895

Contact

Phone: (419)738-3410
Fax: (419)738-7818
information@auglaizehealth.org

Hours

Mon - Fri,    8:00 a.m.- 4:30 p.m

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