Community Health Resources and Clinics
Housatonic Valley Health District is providing full-time public health services to all the citizens of our member communities. We are offering a new program for people with on-going health conditions which is designed to complement the care that people receive from their health care providers. Our focus is to provide essential programs to assure our residents of a healthy community environment, aid in preventing disease, and promote health through screening, and health education.
Community Health Forms
View/download the HVHD Community Health forms.
|Form Title||Description||Download/View Form|
|Flu Vaccine Consent Form||Complete this form to receive your annual flu vaccine||Download|
|CT Vaccine Program Eligibility Form||Complete this form for child who qualifies for immunization through the Connecticut Vaccine Program since they are under 19 years of age and qualify for one option as listed within the form||Download|
|Unaccompanied Minor Consent Form||Complete this form for unaccompanied minors consenting that they can receive a vaccine from HVHD||Download|
|Foodborne Illness Incident Report||Complete this web-based form to report a foodborne illness||Web Form|
Meet your HVHD Immunization Program Supervisor.
Community Health Nursing Supervisor
Updated: September 19, 2023