South Central Health District Forms

Environmental Health Residency Verification Form

GA DPH Environmental Health Residency Verification Form

*FOOD SERVICE ESTABLISHMENT TEMPORARY WATER INTERRUPTION PLAN*

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Please fill out the form and contact the Laurens County Health Department 478-275-6779 ext. 1 to complete requirements to operate.

Notifiable Disease Reporting Form

Georgia Notifiable Disease Reporting Form

Vital Records Forms

Bleckley County Vital Records

Bleckley County Birth Certificate Request Form
Bleckley County Death Certificate Request Form

Laurens County Vital Records

Laurens County Birth Certificate Request Form
Laurens County Health Department Death Certificate Request Form

Telfair County Vital Records

Telfair County Birth Certificate Request Form
Telfair County Death Certificate Request Form

Wheeler County Vital Records

Wheeler County Vital Records

Well Certification Request Form

Bleckley County Well Certification Form

Dodge County Well Certification Form

Johnson County Well Certification Form

Laurens County Well Certification Form

Montgomery County Well Certification Form

Pulaski County Well Certification Form

Telfair County Well Certification Form

Treutlen County Well Certification Form

Wheeler County Well Certification Form

Wilcox County Well Certification Form