"Serving the people of Harrison, Carroll and Tuscarawas Counties for more than 35 years"
HomeWho We AreWhat We DoLocationsContact Us

Housing / Weatherization

Emergency Services


Staff Resources
Health Forms
Administrative Forms
Education Forms
Family/Community Engagement Forms
Prevention/Mental Health Forms
Disabilities/Transition Forms
Our Locations
Parent Resources
Our Program

ECDHS400-Health History Form

ECDHS403-Medication Error Form

ECDHS404-Medical Statement

ECDHS405-Physical Reminder Letter

ECDHS406-Second Physical Reminder Letter

ECDHS407-Treatment Letter

ECDHS409b-Hemoglobin Screening Results

ECDHS410-Lead Screening Permission Form

ECDHS410a-Lead Screening Results

ECDHS411-Dental Health Record

ECDHS412-Dental Reminder Letter

ECDHS413-Dental Clinic Permission Slip

ECDHS414-Hearning Screen

ECDHS414a-Hearning Referral Letter

ECDHS415-Vision Screening

415a-Vision Referral Letter

ECDHS416a-Toilet Training Information & Individual Plan

ECDHS416b-Potty Training: How to Get the Job Done

ECDHS417-Parent/Guardian Refusal for Follow-up Services

ECDHS418-Communicable Disease Fact Notification Letter

ECDHS420a-Immunization Waiver 

Communicable Disease Fact Sheets (are printed from websites)

ECDHS421-Children with Special Needs

ECDHS422-First Aid Kit Inventory

ECDHS423a-SNA Contact Notes

ECDHS425-Change of Status: Health

ODJFS Health Forms Search

ODJFS01201-Dental First Aid

ODJFS01217-Parent/Guardian Request for Administration of Medication

ODJFS01234-Child Enrollment & Health Information

ODJFS01236-Child Medical/Physical Care Plan

ODJFS01242-Medical, Dental, and General Emergency

ODJFS01299-Incident Report