Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Pitt County Health Department Forms

  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…

  1. Telemedicine (Telehealth) Consent Form

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