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Forms and Applications

 | Size: 251 KB 16th Oct 2017 Raising the Awareness of Sudden Infant Death Syndrome through Outreach and Education PR 20171011 vFinal  | Size: 155 KB 13th Oct 2017 CDPH Taking Action to Increase Hepatitis A Vaccine Supplies HA 20171013 vFinal  | Size: 132 KB 12th Oct 2017 Unhealthy Air Quality in San Benito County-ENG HA 20171012 vfinal  | Size: 150 KB 11th Oct 2017 San Benito Public Health Services Awarded $25000 Grant to Address Pedestrian and Bicycle Safety PR 20171010 vfinal  | Size: 303 KB 10th Oct 2017 Flu Vaccination Flyer 10-26-17  | Size: 135 KB 9th Oct 2017 Prevent the Flu this Season by Getting a Flu Shot PR 20171009  | Size: 216 KB 4th Oct 2017 Free Vaccines  | Size: 155 KB 26th Sep 2017 San Benito County Works to Prevent a Local Hepatitis A Outbreak PR 20170926 vFinal  | Size: 155 KB 25th Sep 2017 HAV PR 20170922 vFinal  | Size: 1 MB 20th Sep 2017 SBC HOME Resource Center RFP  | Size: 111 KB 19th Sep 2017 Employees and Volunteers Serving the Population at Risk for Hepatitis A HA 20170913 vFinal  | Size: 49 KB 19th Sep 2017 SBPH Masking Order PU 20170915 vFinal  | Size: 113 KB 19th Sep 2017 Employers of Custodial Workers Servicing Public and At-Risk Restroom Facilities PA 20170914 vFinal  | Size: 139 KB 19th Sep 2017 Business Owners and Members of the Public HAV PA 20170915 vFinal  | Size: 80 KB 14th Sep 2017 1st Responder Hep A Vaccination HA 20170905 vFinal  | Size: 145 KB 5th Sep 2017 WN PR 20170831 vFinal  | Size: 279 KB 5th Sep 2017 HA PR 20170831 vFinal  | Size: 239 KB 2nd Aug 2017 Pregnant Women Urged to Avoid Going to Areas with Zika Risk SP PR 170801 vFinal  | Size: 159 KB 2nd Aug 2017 Pregnant Women Urged to Avoid Going to Areas with Zika Risk EN PR 170101 vFinal  | Size: 115 KB 28th Jul 2017 Hep A Guidance PA 20170728 vFinal  | Size: 122 KB 30th Jun 2017 Summer Safety PR 20170629 vFinal  | Size: 597 KB 28th Jun 2017 Hep A Flyer 170621 Sp  | Size: 267 KB 28th Jun 2017 Hep A Flyer 170621 Eng  | Size: 83 KB 22nd Jun 2017 CDPH Water Treatment Devices for Nitrate 2016  | Size: 56 KB 22nd Jun 2017 CDPH Nitrate Fact Sheet 2014  | Size: 2 MB 22nd Jun 2017 CDPH110C-DMV  | Size: 2 MB 22nd Jun 2017 CDPH110B-TB  | Size: 3 MB 22nd Jun 2017 CDPH110A-PHS  | Size: 717 KB 14th Jun 2017 SBC PHS Rabies Letter PA 20170614 vFinal  | Size: 107 KB 12th Jun 2017 Norovirus PR 20170526 vFinal  | Size: 343 KB 12th Jun 2017 Norovirus Advisory PA 20170521 vFinal  | Size: 305 KB 12th Jun 2017 gastrointestinal illness PA 20170522 vFinal  | Size: 108 KB 12th Jun 2017 Influenza PA 20170106 vFinal  | Size: 131 KB 12th Jun 2017 Flu Health PA 20170113 vFinal  | Size: 128 KB 12th Jun 2017 Dr Newel New Health Officer Appointed PR 20170228 vFinal  | Size: 105 KB 12th Jun 2017 Zika Travelers Precautions PR 020917 2017  | Size: 374 KB 12th Jun 2017 Tobacco More Available than Milk in San Benito County 03082017  | Size: 92 KB 12th Jun 2017 Summer Safety Tip PR 052517 2017  | Size: 67 KB 12th Jun 2017 Public Health Week PR 040217 2017  | Size: 623 KB 12th Jun 2017 Magellan Diagnostics LeadCare PA 20170607 vFinal  | Size: 159 KB 12th Jun 2017 Healthy Stores Healthy Community Media Advisory Final 2017  | Size: 109 KB 12th Jun 2017 CDPH Salmonella Press Release 06052017  | Size: 109 KB 6th Jun 2017 CDPH Salmonella Press Release 06052017  | Size: 90 KB 24th May 2017 20170524 Norovirus Facts  | Size: 1 MB 18th May 2017 BF_Policy_Brief  | Size: 165 KB 15th May 2017 San Benito County Lactation Accommodation Policy-2010  | Size: 347 KB 15th May 2017 CA Breastfeeding Laws  | Size: 692 KB 31st Mar 2017 The Sacred Hour and Beyond Seminar Flyer  | Size: 67 KB 31st Mar 2017 Public Health Week PR 2017  | Size: 547 KB 29th Mar 2017 Public Health flyer-4-9-16-UPDATED-2-21-17 spanish  | Size: 571 KB 29th Mar 2017 Public Health flyer-4-9-16-UPDATED-2-21-17  | Size: 142 KB 29th Mar 2017 HHSA Emergency Toolkit  | Size: 2 MB 28th Mar 2017 Public Health Week Proclamation 2017 BOS Signed  | Size: 162 KB 23rd Mar 2017 Daily message Wednesday-Healthy Environment  | Size: 162 KB 23rd Mar 2017 Daily message Tuesday-Growing healthy families  | Size: 154 KB 23rd Mar 2017 Daily message Thursday-Walk for Wellness  | Size: 146 KB 23rd Mar 2017 Daily message Monday-Preparing for Emergencies  | Size: 164 KB 23rd Mar 2017 Daily message Friday-Zika Bytes  | Size: 125 KB 28th Feb 2017 Local Small Water System Permit Application 2017  | Size: 225 KB 28th Feb 2017 Body Art Practitioner Application for Registration 2017  | Size: 121 KB 28th Feb 2017 Temp Food Permit Application 2017  | Size: 160 KB 28th Feb 2017 Sewage Disposal System Permit Application 2017  | Size: 148 KB 28th Feb 2017 Septage Pumper Permit Application 2017  | Size: 90 KB 28th Feb 2017 Recreational Health Pool-Spa Annual Permit Application 2017  | Size: 95 KB 28th Feb 2017 Food Facility Permit Application 2017  | Size: 169 KB 28th Feb 2017 Community Event Organizer Permit Application 2017  | Size: 2 MB 26th Jan 2017 CertDeathSpa0  | Size: 225 KB 26th Jan 2017 CertDeathEng-vs112  | Size: 2 MB 26th Jan 2017 CertBirthSpa0  | Size: 230 KB 26th Jan 2017 CertBirthEng-vs111  | Size: 8 MB 19th Jan 2017 CD Manual FINAL PDF version-MW  | Size: 129 KB 19th Jan 2017 20170117-EPA-WhatToDoAfterFlood-816f05021 - Spa  | Size: 387 KB 19th Jan 2017 20170117-EPA-WhatToDoAfterFlood-816f05021 - Eng  | Size: 116 KB 19th Jan 2017 20170113b-FloodCleanUpSafetyPrecautionsHealthAdvisory-Spa  | Size: 116 KB 19th Jan 2017 20170113b-FloodCleanUpSafetyPrecautionsHealthAdvisory-Eng  | Size: 769 KB 19th Jan 2017 20170113-Local Emergency Proclamation - Spa  | Size: 519 KB 19th Jan 2017 20170113-Local Emergency Proclamation - Eng  | Size: 367 KB 14th Dec 2016 rfp-final-december-2016  | Size: 37 KB 14th Dec 2016 contract  | Size: 34 KB 14th Dec 2016 attachment-d-program-budget  | Size: 14 KB 14th Dec 2016 scope-of-work  | Size: 14 KB 14th Dec 2016 cover-sheet-rfp  | Size: 3 MB 16th Nov 2016 HSBI-Report  | Size: 184 KB 24th Oct 2016 all-county-information-notice-i-65_16  | Size: 160 KB 7th Oct 2016 pool-spa-plan-check-application  | Size: 513 KB 6th Sep 2016 SBC GA Handbook -July 14 2016  | Size: 24 KB 14th Jan 2016 Consent for Release Form  | Size: 82 KB 14th Jan 2016 Application Form English  | Size: 206 KB 14th Jan 2016 Application Form Spanish  | Size: 24 KB 14th Jan 2016 Consent for Realase  | Size: 52 KB 6th Jan 2016 Plan check Pools-Spas  | Size: 48 KB 6th Jan 2016 Recreational Health Permit Application  | Size: 3 MB 15th Dec 2015 FOOD FACILITY PLAN CHECK APPLICATION
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Our Agency’s website links to Google Translation as a convenience for those who speak/read languages other than English.  Please be aware that no automated or computerized translation tool produces a perfect translation.  The context of the wording may be lost when translated and some translations may lose the intended meaning. Therefore, the San Benito County Health and Human Services Agency cannot guarantee the accuracy of the translated content. 
If any questions arise concerning the translated version of the website, please refer to the original English version.
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