DeSoto County Health Department - Forms

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Forms Page

H1N1 Forms

Child Consent Form (English)
Adult Consent Form (English)
Consent Form (Español)

Clinic Forms

Authorization to Treat A Minor Child
Child Health History & Physical Check Up:
1 - 14 Days / 2 wks - 2 mos / 12 - 18 mos / 18 mos. - 3 yrs / 3 - 5 yrs / 5 - 10 yrs / 10 - 13 yrs
Patient Triage Form

Dental Forms

Dental Triage Form

Environmental Health Forms

School Health Forms

Popular Services

This page was updated on 8-Oct-09.

Clinic Services - Medical Equipment

Flu Shots - Nurse Administering Vaccine

Dental Services - Dental Office

School Health - DeSoto County School

HIV/STD Service - Image of a red ribbon

STD's & HIV/AIDS

Vital Statistics - Image of Forms

Vital Statistics

WIC & Nutrition - Parent and child smiling

WIC & Nutrition

Disaster Preparedness - Hurricane over Florida

Public Health Preparedness

Prescription Assistance - Image of medication bottles

Prescription Assistance

Tobacco Prevention Program - Snuffed out cigarette

Tobacco Prevention

Reportable Diseases - Image of laboratory workers

Reportable Diseases

Women's Health - Mother and Daughter

Healthy Start - Mother and Child

Environmental Health - River Image

Environmental Health

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