Form Center

Thank you for your interest in sharing your thoughts! We would like to hear from parents of children between 9 and 17 years old who... More… Thank you for your interest in sharing your thoughts! We would like to hear from parents of children between 9 and 17 years old who have received at least one vaccination. If that’s you, please provide the following information and we will contact you to confirm your attendance and provide location details. Focus groups will last approximately 1 1/2 hours and all focus group participants will receive a $30 Amazon gift card. Food and childcare will be provided.Less…

Submit this form to provide feedback on the website or to report an error.

This form is used to request an assessment of a site associated with Phase I Environmental site assessment. Environmental site... More… This form is used to request an assessment of a site associated with Phase I Environmental site assessment. Environmental site assessments will search our records of historic solid waste disposal sites, Onsite Wastewater Treatment Systems (OWTS), clandestine methamphetamine labs, and complaints regarding possible hazardous materials spills or hazardous waste releases. The fee for an environmental site assessment is $55.00 per hour.Less…

Online Dead Animal/Bird Report Submission Form

Use this form to report a public health problem

Your Installers license will expire on December 31, 2019. The fee to renew your license is $40.00. If you wish to renew your license... More… Your Installers license will expire on December 31, 2019. The fee to renew your license is $40.00. If you wish to renew your license with Tri-County Health Department (TCHD), please use the link below to complete an application. Upon receipt of the completed application and certification, we will email you an Annual License Renewal Fee invoice for $40.00. Please upload a copy of your NAWT Certification if you have it and/or copies of contracts with disposal sites. Less…

Form used to report a food poisoning/illness

Use this form to request copies of On-Site Wastewater Treatment System (Septic) property records.

The following checklist will assist you in developing a COVID-19 plan for your business. Not all items below are required for every... More… The following checklist will assist you in developing a COVID-19 plan for your business. Not all items below are required for every business and additional industry-specific requirements may apply. Prior to opening, please review industry-specific guidance provided by the Colorado Department of Health and Environment.Less…

This form is to allow the public to sign up for the Baby & Me - Tobacco Free Program.

Help your clients learn about the Women, Infants, and Children (WIC) program.

Have your recently visited a business that was breastfeeding friendly? Nominate a worksite in Adams, Arapahoe or Douglas Counties to... More… Have your recently visited a business that was breastfeeding friendly? Nominate a worksite in Adams, Arapahoe or Douglas Counties to receive the TCHD Breastfeeding Friendly Worksite certification! Less…

Please share details about your shopping experience.

Thank you for your interest in having Tri-County Health Department information at your upcoming event. Please use this form to tell us... More… Thank you for your interest in having Tri-County Health Department information at your upcoming event. Please use this form to tell us about your event. We appreciate as much notice as possible and would prefer the request be made two weeks in advance. This will improve our ability to meet your needs; however, it does not guarantee a presenter will be available to attend your event. You will receive an email or phone call accepting or declining your invitation within 7 – 10 days of submitting this form. Less…

Certification criteria is simple. A worksite must complete a self-assessment process, have or be in the process of developing a... More… Certification criteria is simple. A worksite must complete a self-assessment process, have or be in the process of developing a breastfeeding support policy, and have a permanent or temporary lactation space available. Less…

TCHD has staff available to provide technical assistance with any part of the process of improving breastfeeding support including... More… TCHD has staff available to provide technical assistance with any part of the process of improving breastfeeding support including setting up a lactation support program or creating a lactation space. Less…

This is the form the public will use to submit CORA requests.