Portsmouth Ohio

Where Southern Hospitality Begins

Files and Forms

Portsmouth City Health Department Files and Forms.

Family Planning Clinic PDF

Financial Information Form PDF

History Form PDF

Male Physical Evaluation History PDF

Patient Billing Information PDF

Pregnancy Testing Form

Privacy Practices

Receipt of Notice of Privacy Practices PDF

No Smoking Sign (8.5 x 11 inches) Please note: If the no smoking symbol is used, it must, in accordance with ORC 3794.06A be printed in color.

H1N1 Influenza Basic Information