Print and fill out forms ahead of time for faster service at the health department.
D-4 Spanish history form 07-12.pdf
Adobe Acrobat document [73.2 KB]
Please print and fill out all forms completely.
Dental Packet Forms for Printing - Barne[...]
Adobe Acrobat document [315.3 KB]
Return completed application forms for the Barnesville Dental Clinic to the Lamar County Health Department.
118 Academy Drive
Barnesville, GA 30204
Return completed application forms for the Franklin Dental Clinic to the Heard County Health Department.
1191 Franklin Parkway
Franklin, GA 30217
Forms for providers
All Georgia physicians, laboratories, and other health care providers are required by law to report patients with specific diseases. Both lab-confirmed and clinical diagnoses are reportable within the time interval specified on the NOTIFIABLE DISEASE/CONDITION REPORTING poster. Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks, and provides a better understanding of disease trends in Georgia.
Reporting of diseases may done through our web-based electronic disease reporting system, SendSS (State Electronic Notifiable Disease Surveillance System). You may also print the GEORGIA NOTIFIABLE DISEASE/CONDITION REPORT FORM below and fax it to our office at 706.845.4350.
Please fill out completely and fax to 706.845.4350.
notifiable report form.pdf
Adobe Acrobat document [604.9 KB]