301 Moody Ave. S.W., Carrollton, OH 44615 330-627-4866 Confidential Fax 330-627-3040

PUBLIC RECORDS REQUEST FORM

To request public records, please call: 330-627-4866 ext. 1522 or fill out the form below.

Immunizations are not Public Record. Please email ccghdadmin@carroll-lhd.org to obtain immunization records.

Requestor Information

Requested Information:

Please list any specific information that would be of assistance to us in processing the request:

How would you like to receive the records?