Local Public Health Sample

Policies and Forms


These sample documents will need to be edited to meet the legal/procedural requirements for your local public health agency.

Bloodborne Pathogen Exposure Control Plan | Job Description – Family Planning Consultant |
Board of Health Handbook | Job Description – Health Officer |
Building Security Policy | Job Description – Medical Consultant |
Civil Rights-Voluntary Participation Policy | Job Description – Office Manager |
Cleaning For Patient Use Areas | Job Description – Pharmacy Consultant |
Communicable Disease Investigation and Follow Up Policy | Internet, Email, Password and Comupter Policy |
Communication And Media Policy | Maintaining Dignity and Privacy of Individuals Policy |
Consumer Complaint Form | Medical Records Policy |
Consumer Complaint Log | Newborn Infant Protection Act |
Consumers Complaints-Resolution Policy And Procedures-Environmental Health | On Call Policy – 24⁄7 Coverage |
Diversity Plan | Orientation Education and Workforce Development Policy |
Dress Code | Performance Appraisal Policy |
Employees Record of Training | Physically Disabled Handicapped and Low Literacy Accessibility Policy |
Equipment Replacement Policy | Policy on Policies |
Establishing Fees Based on Service Cost | Research Policy |
Healthy Kansans Action Plan | Respiratory Protection and Fit Testing Policy |
HIPAA-Policy | Strategic Plan |
Job Description – Administrator | Transportation Release Form For HIPAA |
  Unlawful Workplace Harassment Policy |