Below are forms and/or applications for a variety of programs offered through the Ashtabula County Health Department. You may print off any of these forms for your convenience.
We do NOT accept credit cards or out-of-state checks.
Please make checks or money orders payable to the Ashtabula County Health Department. A return check fee will be charged from the Treasurer’s Office per ORC Section 321.48 for any returned checks.
Ashtabula County Health Department
12 West Jefferson St.
Jefferson, OH 44047
If you would like more detailed information on these programs please select the appropriate link in the Environmental Health section.
Animal bite report form
Food Service Operations
Food Service/Food Establishments Application
Food Service/Food Establishment Plan Review
Temporary Food Service Application & Plan Review
Vending Machine Application
Food Service/Food Establishments Mobile Application
Haulers / Septage & Water
Household Sewage Treatment Systems