FORMS

Environmental Health Services Division

The Environmental Health team enforces the Public Health Code across multiple sectors and regulated establishments within QVHD’s district.

QVHD 2024-2025 Fee Schedule

FOOD ESTABLISHMENTS

Licenses Expire on 1/31/YEAR

Food Service License Application

Temporary Food Event License Application

Temporary Event Sponsoring Agency Form

Itinerant Food Truck License Application

Food Service Plan Review (New Establishments)

Food Service Re-Inspection Request

COSMETOLOGY

Certificates of Compliance Expire on 5/31/YEAR

Cosmetology Certificate of Compliance Application

Tattoo Plan Review Application Form

Cosmetology Plan Review Application

SEPTIC

Septic Application for Permit

Application for Addition, Accessory, Pool (B100A)

Water Treatment Wastewater Application

QVHD As-Built Form

Septic Application for Soil Testing

** Please be advised - Forms page is currently under maintenance (below) **

Forms will be revised & uploaded above this disclaimer (above)

Fee Schedule - please reference 2024-2025’s fee schedule for current service rates (above)

FORMS

CT Agricultural Experiment Station (CAES) Tick Testing Form

Farmers Market

Market Master Registration Form

TICK TESTING

DAYCARE

Request for Childcare/Daycare Inspection

Farmers Market Vendor Information Form

School based health centers

SBHC Enrollment Form Hamden High School

SBHC Enrollment Form - Church Street Elementary

MEDICAL

Opioid Opt-Out Form - Patient Guideline Brochure

Opt-Out/Voluntary Non-Opioid Directive Form

SBHC Behavioral Health Referral Form