Health Forms

Community Involvement Requests

Community Participation Form

Dental

Dental Medical History Form (English)
Dental Medical Clearance Form for Pregnant Patients

Vital Records

Birth Certificate Application
Death Certificate Application

W.I.C.

Special Formula Form

Transferring immunizations records from outside Tennessee

Rutherford County Health Department has made it easier to get transferred and updated immunization records. When submitting a request, please ensure that ALL REQUIRED fields have been completed. A clear copy of immunization and physical records will ensure a timely response. The response time could be up to 1-3 days.