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Planning & Development
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Contact Forms

  1. Application to Serve on a Pitt County Farm and Food Council Action Circle

    PCFFC Action Circles are topic specific groups that will work with community members and organizations to take action on the goals and... More…

  2. Email / Contact the Departments

    This form allows you to contact various Pitt County departments directly. Pitt County welcomes all comments on matters of public... More…

  3. Fire Marshal Contact / Email Form
  1. Coronavirus (COVID-19) Response Information

    This form allows you to contact the Public Information Office directly, for any questions or concerns you have related to Pitt County... More…

  2. Farmers' Market / Email Form
  3. Making Pitt Fit Community Garden / Email Form

Pitt County Health Department Forms

  1. COVID-19 Community Request to Host COVID-19 Vaccine Clinic

    This form is intended for community groups who would like to host a COVID-19 vaccine clinic at their location.

  2. Telemedicine (Telehealth) Consent Form

    The Telemedicine (Telehealth) Consent Form is used by patients who request to receive healthcare services from Pitt County Health... More…

  1. Pitt County Health Department Student Placement Application

    This form serves as a application for high school and college students requesting internships and / or other contact hours at Pitt... More…

Risk Management

  1. Workplace Hazard Report Form

    This form allows you to anonymously report potential safety hazards throughout the facilities and grounds of Pitt County Government... More…

Social Services Forms

  1. Contact PITTworks

    An email contact form that can be used by someone who does not have their own email account.

  2. Public Comment Information Sheet

    Citizens who wish to speak at a Social Services Board meeting during the Public Address section need to complete and email in this... More…

  1. Do I Qualify for PITTworks?

    A form by which potential PITTworks clients can determine whether they are either: 1) eligible to participate as a way of preserving... More…

Soil and Water Conservation District

  1. Ag Center Conference Room Reservation Request

    Ag Center Conference Room Reservation Request Form Please fill out the form completely to reserve the Pitt County Ag Center conference... More…

Solid Waste & Recycling

  1. Illegal Dumping Online Reporting Form

    Online reporting form for illegal dumping activities within Pitt County.

  1. North Carolina Scrap Tire Certification

Whistleblower

  1. Whistleblower Information Submission

    Pitt County's Whistleblower Policy was adopted by the County Commissioners to formalize a mechanism for reporting suspected fraud... More…