CT.GOV-Connecticut's Official State Website



[pic]

STATE OF CONNECTICUT

DEPARTMENT OF PUBLIC HEALTH

Local Health Administration Branch

Directory

Local Directors of Health

in Connecticut

Spring 2007

410 Capitol Ave

MS# 11LOC

Hartford, CT 06134

Phone: (860) 509-7660

Fax: (860) 509-7782



Email Addresses:

P. Kilbey-Fox pamela.kilbey-fox@po.state.ct.us

J. Estrada: juanita.estrada@po.state.ct.us

S. Walden: sue.walden@po.state.ct.us

P. Mitchell: peter.mitchell@po.state.ct.us

B. Dingfelder barbara.dingfelder@po.state.ct.us

D. Hunt david.hunt@po.state.ct.us

L. Shannon: lora.shannon@po.state.ct.us

TABLE OF CONTENTS

Local Directors of Health 1

State Map Showing Location Of Local Health Departments/Districts 35

List Of District Health Departments 37

Principal Communities In The State Of Connecticut 38

List Of Reportable Diseases And Reporting Procedures 42

List Of Reportable Laboratory Findings 43

Physician's Report of Occupational Disease 44

Please Note

Due to frequent changes occurring in local health departments (new director appointments, addresses, telephone number, etc.) this publication may not reflect the current information for a given town or health district.

A current listing is also available through our web site:

For confirmation of a specific listing, or for more information, please call the Local Health Administration Branch at (860) 509-7660.

LOCAL DIRECTORS OF HEALTH

*Andover

See Eastern Highlands Health District

*Ansonia

See Naugatuck Valley Health District

*Ashford

See Eastern Highlands Health District

*Avon

See Farmington Valley Health District

*Barkhamsted

See Farmington Valley Health District

*Beacon Falls

See Naugatuck Valley Health District

*Berlin

See Central Connecticut Health District

*Bethany

See Quinnipiack Health District

*Bethel

|Laura Vasile, MPH, RS | Health Dept: (203) 794-8539 |

|Director of Health | Town Hall: |

|Bethel Health Department | Fax: (203) 794-8145 |

|1 School Street | |

| | |

|Bethel, CT 06801-0274 | |

| | Email: VasileL@ |

*Bethlehem

See Torrington Area Health District

*Bloomfield

See West Hartford-Bloomfield Health District

*Bolton

See Eastern Highlands Health District

*Bozrah

See Uncas Health District

*Branford

See East Shore Health District

*Bridgeport

|Marian Evans, MD | Health Dept: (203) 576-7680 |

|Director of Health | Town Hall: (203) 576-7201 |

|Bridgeport Health Department | Fax: (203) 576-7816 |

|752 East Main Street | |

| | |

|Bridgeport, CT 06608-2335 | |

| | Email: |

*Bridgewater

Newtown Health District

*Bristol

See Bristol-Burlington Health District

Bristol-Burlington Health District

|Patricia J. Checko, MPH, DrPH | Health Dept: (860) 584-7682 |

|Director of Health | Town Hall: |

|Bristol-Burlington Health District | Fax: (860) 584-3814 |

|240 Stafford Ave | |

| | |

|Bristol, CT 06010-4617 | |

| | Email: PatriciaChecko@ci.bristol.ct.us |

Brookfield

|Robert Mascia, MD | Health Dept: (203) 775-7315 |

|Director of Health | Town Hall: (203) 775-7315 |

|Town of Brookfield | Fax: (203) 740-7677 |

|100 Pocono Road | |

|P.O. Box 5106 | |

|Brookfield, CT 06804 | |

| | Email: MMcCarthy@ |

*Brooklyn

See Northeast District Department of Health

*Burlington

See Bristol-Burlington Health District

*Canaan

See Torrington Area Health District

*Canterbury

See Northeast District Department of Health

*Canton

See Farmington Valley Health District

Central Connecticut Health District

|Paul Hutcheon, MPH, RS | Health Dept: (860) 721-2822 |

|Director of Health | Town Hall: |

|Central Connecticut Health District | Fax: (860) 721-2823 |

|505 Silas Deane Hwy | |

| | |

|Wethersfield, CT 06109 | |

| | Email: paul.hutcheon@ |

*Chaplin

See Eastern Highlands Health District

Chatham Health District

|Thad D. King, MPH, RS | Health Dept: (860) 267-9601 |

|Director of Health | Town Hall: (860) 267-4468 |

|Chatham Health District | Fax: (860) 267-6430 |

|20 East High Street | |

| | |

|East Hampton, CT 06424 | |

| | Email: healthdirector@ |

*Cheshire

See Chesprocott Health District

Chesprocott Health District

|Thomas Wegrzyn, MPH, RS | Health Dept: (203) 272-2761 |

|Director of Health | Town Hall: |

|Chesprocott Health District | Fax: (203) 250-9412 |

|1247 Highland Ave | |

| | |

|Cheshire, CT 06410 | |

| | Email: chesprocott@ |

Chester

|Konrad Kotrady, MD | Health Dept: (860) 526-0013 |

|Director of Health | Town Hall: (860) 526-0013 |

|Town of Chester | Fax: (860) 526-0004 |

|203 Middlesex Ave. | |

| | |

|Chester, CT 06412 | |

| | Email: info@ |

*Clinton

See Connecticut River Area Health District

*Colchester

|Wendy Mis, MPH | Health Dept: (860) 537-7214 |

|Director of Health | Town Hall: (860) 537-7280 |

|Colchester Health Department | Fax: (860) 537-7287 |

|127 Norwich Avenue | |

| | |

|Colchester, CT 06415 | |

| | Email: Healthdirector@ |

*Colebrook

See Farmington Valley Health District

*Columbia

See Eastern Highlands Health District

Connecticut River Area Health District

|Mary Jane Engle, RS MPH | Health Dept: (860) 395-2482 |

|Director of Health | Town Hall: |

|Connecticut River Area Health District | Fax: (860) 395-6603 |

|302 Main Street | |

| | |

|Old Saybrook, CT 06475 | |

| | Email: mengle@ |

*Cornwall

See Torrington Area Health District

*Coventry

See Eastern Highlands Health District

Cromwell

|Alan Rutner, MD | Health Dept: (860) 632-3426 |

|Director of Health | Town Hall: (860) 632-3410 |

|Town of Cromwell | Fax: (860) 632-3477 |

|41 West Street, Municipal Center | |

| | |

|Cromwell, CT 06416-3424 | |

| | Email: wbma1acr@ |

*Danbury

|Scott T. LeRoy, MPH, MS | Health Dept: (203) 797-4625 |

|Director of Health | Town Hall: (203) 797-4500 |

|Danbury Health and Housing Department | Fax: (203) 796-1596 |

|155 Deer Hill Avenue | |

| | |

|Danbury, CT 06810 | |

| | Email: s.leroy@ci.danbury.ct.us |

Darien

|Margaret M. McLaughlin, MD, MPH | Health Dept: (203) 656-7320 |

|Director of Health | Town Hall: (203) 656-7300 |

|Town of Darien | Fax: (203) 656-7486 |

|2 Renshaw Road | |

| | |

|Darien, CT 06820-5397 | |

| | Email: VProto@ci.darien.ct.us |

*Deep River

See Connecticut River Area Health District

*Derby

See Naugatuck Valley Health District

Durham

|Bradford W. Wilkinson, MD | Health Dept: (860) 349-8253 |

|Acting Director of Health | Town Hall: |

|Town of Durham | Fax: (860) 349-0764 |

|c/o Coginchaug Family Practice | |

|13 Middlefield Road | |

|Durham, CT 06422 | |

| | Email: bmilardo@ |

*East Granby

See Farmington Valley Health District

*East Haddam

See Chatham Health District

*East Hampton

See Chatham Health District

*East Hartford

|James Cordier, MPH, RS | Health Dept: (860) 291-7324 |

|Director of Health and Social Services | Town Hall: (860) 291-7200 |

|East Hartford Health Department | Fax: (860) 291-7304 |

|740 Main Street | |

| | |

|East Hartford, CT 06108 | |

| | Email: jcordier@ci.east-hartford.ct.us |

*East Haven

See East Shore Health District

*East Lyme

See Ledge Light Health District

East Shore Health District

|James Monopoli, MPH | Health Dept: (203) 481-4233 |

|Director of Health | Town Hall: |

|East Shore Health District | Fax: (203) 483-6894 |

|14 Business Park Dr. | |

| | |

|Branford, CT 06405 | |

| | Email: |

*East Windsor

See North Central Health District

Eastern Highlands Health District

|Robert L. Miller, MPH, RS | Health Dept: (860) 429-3325 |

|Director of Health | Town Hall: |

|Eastern Highlands Health District | Fax: (860) 429-3321 |

|4 South Eagleville Rd | |

| | |

|Mansfield, CT 06268 | |

| | Email: EHHD@ |

*Eastford

See Northeast District Department of Health

Easton

|Christopher Michos, MD | Health Dept: |

|Director of Health | Town Hall: (203) 268-6291 |

|Town of Easton | Fax: (203) 268-4928 |

|225 Center Road | |

| | |

|Easton, CT 06612 | |

| | Email: P_edwards@ |

*Ellington

See North Central Health District

*Enfield

See North Central Health District

Essex

|Christopher Goff, MD | Health Dept: (860) 767-4340 |

|Director of Health | Town Hall: (860) 767-4340 |

|Town of Essex | Fax: (860) 767-8509 |

|29 West Ave. | |

| | |

|Essex, CT 06426 | |

| | Email: cspeer@ |

*Fairfield

|Arthur Leffert, MS, RS | Health Dept: (203) 256-3020 |

|Director of Health | Town Hall: (203) 256-3000 |

|Fairfield Health Department | Fax: (203) 256-3080 |

|725 Old Post Road | |

| | |

|Fairfield, CT 06824 | |

| | Email: aleffert@town.fairfield.ct.us |

*Farmington

See Farmington Valley Health District

Farmington Valley Health District

|Richard H. Matheny, Jr., MPH, MFS, RS | Health Dept: (860) 676-1953 |

|Director of Health | Town Hall: |

|Farmington Valley Health District | Fax: (860) 676-2131 |

|50 Avon Meadow Lane | |

|P.O. Box 529 | |

|Avon, CT 06001 | |

| | Email: info@ |

Franklin

|Robert W. Powitz, Ph.D, MPH | Health Dept: |

|Acting Director of Health | Town Hall: (860) 642-7352 |

|Town of Franklin | Fax: (860) 388-9566 |

|7 Meetinghouse Hill Road | |

| | |

|North Franklin, CT 06254 | |

| | Email: sanitarian@ |

*Glastonbury

|David Boone, MPH RS | Health Dept: (860) 652-7534 |

|Director of Health | Town Hall: (860) 652-7500 |

|Glastonbury Health Department | Fax: (860) 652-7533 |

|2155 Main St | |

|P.O. Box 6523 | |

|Glastonbury, CT 06033 | |

| | Email: david.boone@glastonbury- |

*Goshen

See Torrington Area Health District

*Granby

See Farmington Valley Health District

*Greenwich

|Caroline C. Baisley, MPH | Health Dept: (203) 622-7836 |

|Director of Health | Town Hall: (203) 622-7899 |

|Greenwich Health Department | Fax: (203) 622-7770 |

|101 Field Point Rd | |

|P.O. Box 2540 | |

|Greenwich, CT 06830-2540 | |

| | Email: cbaisley@ |

Griswold

|Albert Gosselin, MD | Health Dept: (860) 376-7060 |

|Director of Health | Town Hall: |

|Town of Griswold | Fax: (860) 376-3789 |

|28 Main Street | |

| | |

|Jewett City, CT 06351 | |

| | Email: agosselin@griswold- |

*Groton (Town)

See Ledge Light Health District

*Guilford

|Dennis Johnson, MPH,RS | Health Dept: (203) 453-8118 |

|Director of Health | Town Hall: (203) 453-8029 |

|Guilford Health Department | Fax: (203) 453-8034 |

|50 Boston St | |

|Town Hall South | |

|Guilford, CT 06437 | |

| | Email: johnsond@ci.guilford.ct.us |

Haddam

|Thad King, MPH, RS | Health Dept: |

|Acting Director of Health | Town Hall: (860) 345-8531 |

|Town of Haddam | Fax: (860) 345-5169 |

|30 Field Park Drive | |

| | |

|Haddam, CT 06438 | |

| | Email: healthdirector@ |

*Hamden

See Quinnipiack Valley Health District

*Hampton

See Northeast District Department of Health

*Hartford

|Carlos Rivera, MBA, LMSW | Health Dept: (860) 543-8860 |

|Acting Director of Health | Town Hall: |

|Hartford Health Department | Fax: (860) 722-6791 |

|2 Holcomb Street | |

| | |

|Hartford, CT 06112 | |

| | Email: rivec003@ |

*Hartland

See Farmington Valley Health District

*Harwinton

See Torrington Health District

*Hebron

See Chatham Health District

*Kent

See Torrington Area Health District

*Killingly

See Northeast District Department of Health

Killingworth

|Edward Winokur, MD | Health Dept: |

|Director of Health | Town Hall: (860) 663-1616 |

|Town of Killingworth | Fax: (860) 669-4382 |

|27 Commerce St | |

| | |

|Clinton, CT 06413 | |

| | Email: mklein@ |

Lebanon

|Robert W. Powitz, Ph.D, MPH | Health Dept: |

|Acting Director of Health | Town Hall: (860) 642-6028 |

|Town of Lebanon | Fax: (860) 388-9566 |

|579 Exeter Road | |

| | |

|Lebanon, CT 06249 | |

| | Email: Raya@ |

Ledge Light Health District

|Baker Salsbury, MPH, MSW, MHSA | Health Dept: (860) 448-4882 |

|Director of Health | Town Hall: |

|Ledge Light Health District | Fax: (860) 446-3062 |

|943 North Road (Route 117) | |

|P.O. Box 909 | |

|Groton, CT 06340 | |

| | Email: bsalsbury@ |

*Ledyard

See Ledge Light Health District

Lisbon

|Albert Gosselin, MD | Health Dept: (860) 376-7060 |

|Director of Health | Town Hall: |

|Town of Lisbon | Fax: (860) 376-3789 |

|28 Main Street | |

| | |

|Jewett City, CT 06351 | |

| | Email: agosselin@griswold- |

*Litchfield (Town)

See Torrington Area Health District

Lyme

|Dana Cavicke, MD | Health Dept: (860) 434-7733 |

|Director of Health | Town Hall: |

|Town of Lyme | Fax: (860) 434-2989 |

|1250 Boston Post Rd. | |

| | |

|Old Saybrook, CT 06475 | |

| | Email: lymehealth@ |

*Madison

|John N. Bowers, MS, RS | Health Dept: (203) 245-5681 |

|Director of Health | Town Hall: (203) 245-5602 |

|Madison Health Department | Fax: (203) 245-5613 |

|8 Campus Dr | |

| | |

|Madison, CT 06443 | |

| | Email: bowersjn@ |

*Manchester

|Maryann Cherniak Lexius, MPH, RS | Health Dept: (860) 647-3173 |

|Director of Health | Town Hall: |

|Manchester Health Department | Fax: (860) 647-3188 |

|479 Main St | |

|P.O. Box 191 | |

|Manchester, CT 06045-0191 | |

| | Email: health_dept@ci.manchester.ct.us |

*Mansfield

See Eastern Highlands Health District

*Marlborough

See Chatham Health District

*Mashantucket Pequot Health Department

|Amarillys Rodriguez, MD | Health Dept: (860) 312-8000 |

|Medical Director | Town Hall: |

|Mashantucket Pequot Health Department | Fax: (860) 889-7557 |

|P.O.Box 3179 | |

| | |

|Mashantucket, CT 06339 | |

| | Email: arodriguez@ |

*Meriden

|Beth Vumbaco, RN, MS | Health Dept: (203) 630-4221 |

|Director of Health | Town Hall: (203) 630-4123 |

|Meriden Dept. of Health | Fax: (203) 639-0039 |

|165 Miller St | |

| | |

|Meriden, CT 06450 | |

| | Email: bvumbaco@ci.meriden.ct.us |

Middlebury

|Raymond Sullivan, MD | Health Dept: (203) 577-4011 |

|Director of Health | Town Hall: (203) 758-1779 |

|Town of Middlebury | Fax: (203) 598-7640 |

|1212 Whittemore Road | |

|P.O.Box 392 | |

|Middlebury, CT 06762 | |

| | Email: hoboinspector@middlebury- |

Middlefield

|Matthew Huddleston, MD | Health Dept: (860) 349-7123 |

|Director of Health | Town Hall: (860) 349-7114 |

|Town of Middlefield | Fax: (860) 349-7115 |

|405-1 Main Street | |

| | |

|Middlefield, CT 06455 | |

| | Email: tom.health1@ |

*Middletown

|Joseph A. Havlicek, MD | Health Dept: (860) 344-3474 |

|Director of Health | Town Hall: |

|Middletown Health Department | Fax: (860) 344-3588 |

|245 DeKoven Drive | |

|PO Box 1300 | |

|Middletown, CT 06457 | |

| | Email: joseph.havlicek@ |

*Milford

|Andrew Dennis McBride, MD, MPH | Health Dept: (203) 783-3285 |

|Director of Health | Town Hall: (203) 783-3200 |

|Milford Health Department | Fax: (203) 783-3286 |

|82 New Haven Avenue | |

| | |

|Milford, CT 06460-4827 | |

| | Email: health@ci.milford.ct.us |

*Mohegan Tribal Health

|Scott Sjoquist, MS | Health Dept: (860) 862-6158 |

|Director of Health | Town Hall: |

|Mohegan Tribal Health | Fax: (860) 862-6189 |

|5 Crow Hill Road | |

| | |

|Uncasville, CT 06382 | |

| | Email: ssjoquist@ |

*Monroe

See Trumbull-Monroe Health District

*Montville

See Uncas Health District

*Morris

See Torrington Area Health District

*Naugatuck

See Naugatuck Valley Health District

Naugatuck Valley Health District

|Karen N. Spargo, MPH, MA, RS | Health Dept: (203) 881-3255 |

|Director of Health | Town Hall: |

|Naugatuck Valley Health District | Fax: (203) 881-3259 |

|98 Bank St. | |

| | |

|Seymour, CT 06483 | |

| | Email: |

*New Britain

|Eugene Ciccone, MD | Health Dept: (860) 612-2771 |

|Director of Health | Town Hall: |

|New Britain Health Department | Fax: (860) 826-3475 |

|56 Hawkins Street | |

| | |

|New Britain, CT 06052 | |

| | Email: eciccone@ch.ci.new-britain.ct.us |

*New Canaan

|Richard Werner, MPH, RS | Health Dept: (203) 594-3018 |

|Director of Health | Town Hall: |

|Town of New Canaan | Fax: (203) 594-3125 |

|77 Main Street | |

| | |

|New Canaan, CT 06840 | |

| | Email: rick.werner@ci.new-canaan.ct.us |

*New Fairfield

|Timothy Simpkins, RS, MA | Health Dept: (203) 312-5640 |

|Director of Health | Town Hall: (203) 312-5600 |

|New Fairfield Health Department | Fax: (203) 312-5608 |

|4 Brush Hill Road | |

| | |

|New Fairfield, CT 06812-2665 | |

| | Email: jmcgowan@ |

*New Hartford

See Farmington Valley Health District

*New Haven

|William P. Quinn, MPH | Health Dept: (203) 946-6999 |

|Director of Health | Town Hall: |

|New Haven Health Department | Fax: (203) 946-7234 |

|54 Meadow Street, 9th Floor | |

| | |

|New Haven, CT 06519 | |

| | Email: nhhealthdept@ |

*New London

See Ledge Light Health District

*New Milford

|Michael A. Crespan, MPH, RS | Health Dept: (860) 355-6035 |

|Director of Health | Town Hall: (860) 355-6035 |

|New Milford Health Department | Fax: (860) 210-2664 |

|10 Main Street | |

| | |

|New Milford, CT 06776 | |

| | Email: mcrespan@ |

*Newington

See Central Connecticut Health District

*Newtown

See Newtown Health District

Newtown Health District

|Donna Culbert, MPH, PE, RS | Health Dept: (203) 270-4291 |

|Director of Health | Town Hall: |

|Newtown Health District | Fax: (203) 270-1528 |

|31 Pecks Lane | |

| | |

|Newtown, CT 06470-2104 | |

| | Email: newtownhd@ |

*Norfolk

See Torrington Area Health District

*North Branford

See East Shore Health District

*North Canaan

See Torrington Area Health District

North Central Health District

|William H. Blitz, MPH, MUP, RS | Health Dept: (860) 745-0383 |

|Director of Health | Town Hall: |

|North Central Health District | Fax: (860) 745-3188 |

|31 North Main Street | |

|P.O. Box 1222 | |

|Enfield, CT 06083 | |

| | Email: bblitz@ |

*North Haven

See Quinnipiack Valley Health District

North Stonington

|Kenneth R. Larsen, DO | Health Dept: |

|Director of Health | Town Hall: (860) 535-2877 |

|Town of North Stonington | Fax: (860) 599-6071 |

|382 Grindstone Hill Rd | |

| | |

|North Stonington, CT 06359 | |

| | Email: |

Northeast District Department of Health

|Patricia Beckenhaupt, RN, MS, MPH | Health Dept: (860) 774-7350 |

|Director of Health | Town Hall: |

|Northeast District Department of Health | Fax: (860) 774-1308 |

|69 South Main Street | |

|Unit 4 | |

|Brooklyn, CT 06234 | |

| | Email: email@ |

*Norwalk

|Timothy Callahan, MPH, RS | Health Dept: (203) 854-7776 |

|Director of Health | Town Hall: (203) 854-7868 |

|Norwalk Health Department | Fax: (203) 854-7934 |

|137-139 East Avenue | |

| | |

|Norwalk, CT 06851 | |

| | Email: tcallahan@ |

*Norwich

See Uncas Health District

Old Lyme

|Vijay Sikand, MD | Health Dept: (860) 434-1605 x214 |

|Director of Health | Town Hall: (860) 434-1605 |

|Town of Old Lyme | Fax: (860) 434-9283 |

|52 Lyme Street | |

| | |

|Old Lyme, CT 06371 | |

| | Email: healthdept@oldlyme- |

*Old Saybrook

See Connecticut River Area Health District

Orange

|Joseph Zelson, MD | Health Dept: (203) 891-2122 |

|Director of Health | Town Hall: |

|Town of Orange | Fax: (203) 799-1554 |

|605A Orange Center Rd | |

| | |

|Orange, CT 06477 | |

| | Email: jzelson@ |

*Oxford

See Pomperaug Health District

*Plainfield

See Northeast District Department of Health

Plainville

|William A. Petit, Jr., MD | Health Dept: (860) 793-0221 |

|Director of Health | Town Hall: (860) 793-0221 |

|Town of Plainville | Fax: (860) 747-1123 |

|1 Central Square | |

| | |

|Plainville, CT 06062 | |

| | Email: health@plainville- |

*Plymouth

See Torrington Area Health District

*Pomfret

See Northeast District Department of Health

Pomperaug Health District

|Neal Lustig, MPH, RS | Health Dept: (203) 264-9616 |

|Director of Health | Town Hall: |

|Pomperaug Health District | Fax: (203) 262-1960 |

|800 Main St, Suite 130 | |

| | |

|Southbury, CT 06488 | |

| | Email: pomphealth@ |

*Portland

See Chatham Health District

Preston

|Albert Gosselin, MD | Health Dept: (860) 376-7060 |

|Director of Health | Town Hall: |

|Town of Preston | Fax: (860) 376-3789 |

|28 Main Street | |

| | |

|Jewett City, CT 06351 | |

| | Email: agosselin@griswold- |

*Prospect

See Chesprocott Health District

*Putnam

See Northeast District Department of Health

Quinnipiack Valley Health District

|Leslie Balch, MPH | Health Dept: (203) 248-4528 |

|Director of Health | Town Hall: |

|Quinnipiack Valley Health District | Fax: (203) 248-6671 |

|1151 Hartford Tpke | |

| | |

|North Haven, CT 06473 | |

| | Email: info@ |

Redding

|Lawrence Leibowitz, MD | Health Dept: |

|Director of Health | Town Hall: (203) 938-2559 |

|Town of Redding | Fax: (203) 938-5027 |

|c/o Ridgefield Primary Care | |

|10 South Street | |

|Ridgefield, CT 06877 | |

| | Email: HEALTH@ |

*Ridgefield

|Edward Briggs, MPH, MS, RS | Health Dept: (203) 431-2746 |

|Director of Health | Town Hall: (203) 431-2745 |

|Town of Ridgefield | Fax: (203) 431-1804 |

|66 Prospect Street | |

| | |

|Ridgefield, CT 06877 | |

| | Email: eb.health@ |

*Rocky Hill

See Central Connecticut Health District

*Roxbury

Newtown Health District

Salem

|Robert W. Powitz, Ph.D, MPH | Health Dept: |

|Acting Director of Health | Town Hall: (860) 859-3873 |

|Town of Salem | Fax: (860) 388-9566 |

|Salem Town Hall | |

|270 Hartford Road | |

|Salem, CT 06420 | |

| | Email: sanitarian@ |

*Salisbury

See Torrington Area Health District

*Scotland

See Eastern Highlands Health District

*Seymour

See Naugatuck Valley Health District

Sharon

|Daniel Baroody, MPH, RS | Health Dept: |

|Director of Health | Town Hall: (860) 364-5224 |

|Town of Sharon | Fax: (860) 364-9397 |

|63 Main Street | |

|P.O. Box 224 | |

|Sharon, CT 06069 | |

| | Email: |

*Shelton

See Naugatuck Valley Health District

Sherman

|Timothy Simpkins, MA, RS | Health Dept: |

|Acting Director of Health | Town Hall: (860) 355-0166 |

|Town of Sherman | Fax: (860) 350-5041 |

|Mallory Town Hall | |

|PO Box 39 | |

|Sherman, CT 06784 | |

| | Email: bldhlthiw@ |

*Simsbury

See Farmington Valley Health District

Somers

|Richard A. Segool, MD | Health Dept: 860-763-8216 |

|Director of Health | Town Hall: (860) 763-8206 |

|Town of Somers | Fax: (860) 763-8223 |

|P.O. Box 308 | |

| | |

|Somers, CT 06071 | |

| | Email: wpca@townofsomers. |

South Windsor

|Gerald L. Schwartz, MD | Health Dept: (860) 644-2511 |

|Director of Health | Town Hall: |

|Town of South Windsor | Fax: (860) 644 - 3781 |

|1540 Sullivan Avenue | |

| | |

|South Windsor, CT 06074 | |

| | Email: deptul@ |

*Southbury

See Pomperaug Health District

*Southington

|Charles I. Motes, Jr., MS, MPH, RS | Health Dept: (860) 276-6275 |

|Director of Health | Town Hall: (860) 276-6200 |

|Southington Health Department | Fax: (860) 276-6277 |

|93 Main Street | |

| | |

|Southington, CT 06489 | |

| | Email: motesc@ |

*Sprague

See Uncas Health District

*Stafford

See North Central Health District

*Stamford

|Johnnie Lee, MD, MPH, FACP | Health Dept: (203) 977-4398 |

|Director of Health | Town Hall: (203) 977-4150 |

|Stamford Health Department | Fax: (203) 977-5506 |

|888 Washington Boulevard, 8th fl. | |

| | |

|Stamford, CT 06904-2152 | |

| | Email: jalee@ci.stamford.ct.us |

*Sterling

See Northeast District Department of Health

Stonington

|Michael Blefeld, MD | Health Dept: (860)-535-5010 |

|Director of Health | Town Hall: (860) 535-4721 |

|Town of Stonington | Fax: (860) 449-9195 |

|152 Elm Street | |

| | |

|Stonington, CT 06378 | |

| | Email: kweiss@stonington- |

*Stratford

|Lisa LoBianco, MPH | Health Dept: (203) 385-4090 |

|Director of Health | Town Hall: |

|Stratford Health Department | Fax: (203) 381-2048 |

|468 Birdseye Street | |

| | |

|Stratford, CT 06615 | |

| | Email: healthdepartment@ |

*Suffield

See North Central Health District

*Thomaston

See Torrington Area Health District

*Thompson

See Northeast District Department of Health

*Tolland

See Eastern Highlands Health District

*Torrington

See Torrington Area Health District

Torrington Area Health District

|James Rokos, MPH, MS, RS | Health Dept: (860) 489-0436 |

|Director of Health | Town Hall: |

|Torrington Area Health District | Fax: (860) 496-8243 |

|350 Main St | |

| | |

|Torrington, CT 06790 | |

| | Email: jrokos@ |

*Trumbull

See Trumbull-Monroe Health District

Trumbull-Monroe Health District

|Judith Wrenn, MPH | Health Dept: (203) 452-5195 |

|Director of Health | Town Hall: (203) 452-5005 |

|Trumbull-Monroe Health District | Fax: (203) 452-5180 |

|Town Hall Annex | |

|5892 Main Street | |

|Trumbull, CT 06611 | |

| | Email: health@trumbull- |

Uncas Health District

|Patrick McCormack, MPH | Health Dept: (860) 823-1189 |

|Director of Health | Town Hall: |

|Uncas Health District | Fax: (860) 887-7898 |

|372 West Main St, 2nd fl | |

| | |

|Norwich, CT 06360-5450 | |

| | Email: doh@ |

*Union

See Northeast Health District

*Vernon

See North Central Health District

Voluntown

|Albert Gosselin, MD | Health Dept: (860) 376-7060 |

|Director of Health | Town Hall: |

|Town of Voluntown | Fax: (860) 376-3789 |

|28 Main Street | |

| | |

|Jewett City, CT 06351 | |

| | Email: agosselin@griswold- |

*Wallingford

|Eloise Hudd, MPH | Health Dept: (203) 294-2065 |

|Director of Health | Town Hall: (203) 294-2065 |

|Wallingford Health Department | Fax: (203) 294-2064 |

|45 South Main Street, Room 105 | |

| | |

|Wallingford, CT 06492 | |

| | Email: wlfdhealth@ |

*Warren

See Torrington Area Health District

Washington

|Michael A. Crespan, MPH, RS | Health Dept: (860) 355-6035 |

|Acting Director of Health | Town Hall: |

|Town of Washington | Fax: (860) 210-2664 |

|P.O. Box 383 | |

| | |

|Washington Depot, CT 06794 | |

| | Email: mcrespan@ |

*Waterbury

|William Campbell, B.Ed., MPH | Health Dept: (203) 574-6780 |

|Director of Health | Town Hall: |

|Waterbury Health Department | Fax: (203) 597-3481 |

|95 Scovill Street, Suite 100 | |

| | |

|Waterbury, CT 06706 | |

| | Email: |

*Waterford

See Ledge Light Health District

*Watertown

See Torrington Area Health District

*West Hartford

See West Hartford-Bloomfield Health District

West Hartford-Bloomfield Health District

|Steven Huleatt, MPH, RS | Health Dept: (860) 561-7900 |

|Director of Health | Town Hall: |

|West Hartford-Bloomfield Health District | Fax: (860) 561-7918 |

|693-C Bloomfield Ave. | |

| | |

|Bloomfield, CT 06002 | |

| | Email: WHBHD@ |

*West Haven

|Eric Triffin, MPH | Health Dept: (203) 937-3660 |

|Director of Health | Town Hall: (203) 937-3510 |

|West Haven Health Department | Fax: (203) 937-3676 |

|West Haven Health Department | |

|355 Main Street | |

|West Haven, CT 06516 | |

| | Email: ETriffin@westhaven- |

Westbrook

|Jeffrey Bernstein, MD | Health Dept: (860) 399-3047 |

|Director of Health | Town Hall: (860) 399-3040 |

|Town of Westbrook | Fax: (860) 399-2084 |

|866 Boston Post Road | |

| | |

|Westbrook, CT 06498-0676 | |

| | Email: |

*Weston

See Westport/Weston Health District

*Westport

See Westport/Weston Health District

Westport Weston Health District

|Susan Jacozzi, MPH, CHES | Health Dept: (203) 227-9571 |

|Director of Health | Town Hall: |

|Westport Weston Health District | Fax: (203) 221-7199 |

|180 Bayberry Ln | |

| | |

|Westport, CT 06880 | |

| | Email: publichealth@ |

*Wethersfield

See Central Connecticut Health District

*Willington

See Eastern Highlands Health District

*Wilton

|Steven Schole, MPH, RS | Health Dept: (203) 563-0174 |

|Director of Health | Town Hall: |

|Wilton Health Department | Fax: (203) 563-0148 |

|238 Danbury Road | |

| | |

|Wilton, CT 06897 | |

| | Email: steven.schole@ |

*Winchester

See Torrington Area Health District

*Windham

See North Central Health District

*Windsor

|Charles J. Petrillo, Jr., DrPH, MPH, MSPH | Health Dept: (860) 285-1823 |

|Director of Health | Town Hall: |

|Windsor Health Department | Fax: (860) 285-1864 |

|Town Hall | |

|275 Broad Street | |

|Windsor, CT 06095 | |

| | Email: petrillo@ |

*Windsor Locks

See North Central Health District

*Wolcott

See Chesprocott Health District

*Woodbridge

See Quinnipiack Valley Health District

*Woodbury

See Pomperaug Health District

*Woodstock

See Northeast District Department of Health

[pic]

HISTORICAL SUMMARY OF

HEALTH DISTRICTS IN CONNECTICUT

July, 2006

|ID #. On | | |MEMBER TOWNS |

|Map |DISTRICT |Date | |

| |NAME |Formed | |

| | | | |

|1 |Weston Westport Health District |1966 |Weston, Westport. |

| | | | |

|2 |Torrington Area Health District |1967 |Harwinton, Goshen, Litchfield (Town), Bantam Borough (Litchfield), Litchfield |

| | | |Borough, Morris, Torrington; Cornwall 12/80; Warren 1/81; Winchester 7/83; |

| | | |Bethlehem, Thomaston 7/87; Kent, Salisbury 1/88; Norfolk 3/93; Watertown 7/95; |

| | | |Plymouth 6/98; Canaan 5/01. |

| | | | |

|3 |Naugatuck Valley Health District |1972 |Ansonia, Derby, Seymour, Shelton; Beacon Falls 7/80; Naugatuck 4/85. |

| | | | |

|4 |Northeast Health District |1973 |Brooklyn, Canterbury, Eastford, Killingly, Danielson Borough (Killingly), |

| | | |Plainfield, Pomfret, Putnam, Sterling, Thompson, Woodstock; Ashford withdrawal |

| | | |6/04, Hampton, Voluntown 7/85; Voluntown withdrawal 7/92, Union 7/02 |

| | | | |

|5 |East Shore Health District |1974 |Branford, East Haven, North Branford. |

| | | | |

|6 |North Central Health District |1974 |East Windsor, Ellington, Enfield, Windsor Locks; Suffield 7/84; Vernon 4/93; |

| | | |Windham 4/97, Stafford 7/02 |

| | | | |

|7 |Chesprocott Health District |1975 |Cheshire, Prospect, Wolcott; Watertown 7/81; Watertown withdrawal 7/95. |

| | | | |

|8 |Farmington Valley Health District |1976 |Canton, East Granby, Granby, New Hartford; Barkhamsted 7/77; Hartland 3/80; |

| | | |Simsbury 5/87; Farmington 1/92; Colebrook 4/93; Avon, 5/93. |

| | | | |

|9 |Quinnipiack Valley Health District |1978 |Hamden, North Haven, Woodbridge; Bethany 6/06. |

| | | | |

|10 |Bristol-Burlington Health District |1979 |Bristol, Burlington. |

| | | | |

|11 |Stafford Health District – |1979 |Stafford, Stafford Springs Borough (unified 1991); Union 10/86. |

| |Dissolved 6/30/02 | | |

| | | | |

|12 |Pomperaug Health District |1986 |Southbury, Woodbury; Oxford 8/89. |

| | | | |

|13 |Uncas Health District |1988 |Montville, Norwich, Sprague 1/06; Bozrah 6/06 |

| | | | |

|14 |Ledge Light Health District |1993 |City of Groton, Town of Groton; Ledyard 5/01, Waterford 5/02, New London 7/05; |

| | | |East Lyme 6/06 |

| | | | |

|15 |Newtown Health District |1994 |Borough of Newtown, Town of Newtown, Bridgewater, Roxbury, 1/06 |

| | | | |

|16 |West Hartford-Bloomfield Health District |1995 |Bloomfield, West Hartford. |

| | | | |

|17 |Central Connecticut Health District |1996 |Rocky Hill, Wethersfield; Berlin 6/98; Newington 6/06 |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

|18 |Eastern Highlands Health District |1997 |Bolton, Coventry, Mansfield; Tolland 5/00; Willington 4/01; Ashford 7/04; |

| | | |Andover, Columbia, Chaplin, Scotland 6/05 |

| | | | |

|19 |Chatham Health District |2002 |East Hampton, East Haddam, Hebron, Marlborough, |

| | | |Portland 7/04 |

| | | | |

|20 |Trumbull Monroe Health District |2004 |Trumbull, Monroe |

| | | | |

|21 |Connecticut River Area Health District |2006 |Clinton, Deep River, Old Saybrook |

PRINCIPAL COMMUNITIES IN THE STATE OF CONNECTICUT

|Communites |Towns |Communities |Towns |Communities |Towns |

| | | | | | |

|Abington |Pomfret |Burrville |Torrington |Durham |Durham |

|Addison |Glastonbury |Byram |Greenwich |Durham Center |Durham |

|Allentown |Plymouth | | | | |

|Allingtown |West Haven |Campbell’s Mills |Voluntown |Eagleville |Mansfield |

|Almyville |Plainfield |Campville |Harwinton |East Berlin |Berlin |

|Amenia Union |Sharon |Canaan |North Canaan |East Brooklyn |Brooklyn |

|Amesville |Salisbury |Canaan Valley |North Canaan |East Canaan |North Canaan |

|Amston |Hebron |Cannondale |Wilton |East Cornwall |Cornwall |

|Andover |Andover |Canterbury |Canterbury |Eastford |Eastford |

|Ansonia |Ansonia |Canton |Canton |East Glastonbury |Glastonbury |

|Ashford |Ashford |Canton Center |Canton |East Granby |East Granby |

|Aspetuck |Easton |Centerbrook |Essex |East Haddam |East Haddam |

|Attawaugan |Killingly |Centerhill |Barkhamsted |East Hampton |East Hampton |

|Atwoodville |Mansfield |Centerville |Hamden |East Hartford |East Hartford |

|Augerville |Hamden |Central Village |Plainfield |East Hartland |Hartland |

|Avon |Avon |Chaffeeville |Mansfield |East Haven |East Haven |

| | |Chaplin |Chaplin |East Kent |Kent |

|Baileyville |Middlefield |Cherry Brook |Canton |East Killingly |Killingly |

|Bakersville |New Hartford |Cheshire |Cheshire |East Litchfield |Litchfield |

|Ball Pond |New Fairfield |Chester |Chester |East Lyme |East Lyme |

|Ballouville |Killingly |Chesterfield |Montville |East Meriden |Meriden |

|Baltic |Sprague |Chestnut Hill |Columbia |East Morris |Morris |

|Banksville |Greenwich |Chestnut Hill |Killingly |East Norwalk |Norwalk |

|Bantam |Litchfield |Chestnut Hill |Mansfield |Easton |Easton |

|Barkhamsted |Barkhamsted |Clark Corner |Hampton |East Plymouth |Plymouth |

|Bashan |East Haddam |Clark Falls |North Stonington |East Putnam |Putnam |

|Beacon Falls |Beacon Falls |Clinton |Clinton |East River |Madison |

|Belltown |Stamford |Clintonville |North Haven |East Thompson |Thompson |

|Berkshire |Newtown |Cobalt |East Hampton |East Village |Monroe |

|Berlin |Berlin |Colchester |Colchester |East Wallingford |Wallingford |

|Bethany |Bethany |Colebrook |Colebrook |East Willington |Willington |

|Bethel |Bethel |Collinsville |Canton |East Windsor |East Windsor |

|Bethlehem |Bethlehem |Columbia |Columbia |East Windsor Hill |South Windsor |

|Bill Hill |Lyme |Comstock Bridge |Colchester |East Woodstock |Woodstock |

|Black Hall |Old Lyme |Cornfield Point |Old Saybrook |Edgewood |Bristol |

|Black Point |East Lyme |Cornwall |Cornwall |Ekonk |Sterling |

|Bloomfield |Bloomfield |Cornwall Bridge |Cornwall |Ellington |Ellington |

|Blue Hills |Bloomfield |Cornwall Center |Cornwall |Elliott |Pomfret |

|Boardman’s Bridge |New Milford |Cornwall Hollow |Cornwall |Ellithorpe |Stafford |

|Bolton |Bolton |Cos Cob |Greenwich |Ellsworth |Sharon |

|Bolton Notch |Bolton |Coventry |Coventry |Elmville |Killingly |

|Botsford |Newtown |Cranbury |Norwalk |Elmwood |West Hartford |

|Bozrah |Bozrah |Crescent Beach |East Lyme |Enfield |Enfield |

|Bradleyville |Middlebury |Cromwell |Cromwell |Essex |Essex |

|Branchville |Redding |Crystal Lake |Ellington |Exeter |Lebanon |

|Branford |Branford |Crystal Lake |Stafford | | |

|Bridgeport |Bridgeprot | | |Fabyan |Thompson |

|Bridgewater |Bridgewater |Danbury |Danbury |Fairfield |Fairfield |

|Bristol |Bristol |Danielson |Killingly |Fair Haven |New Haven |

|Broadbrook |East Windsor |Darien |Darien |Falls Village |Canaan |

|Brookfield |Brookfield |Dayville |Killingly |Farmington |Farmington |

|Brookfield Center |Brookfield |Deep River |Deep River |Fenwick |Old Saybrook |

|Brooklyn |Brooklyn |Deerfield |Windsor |Fitchville |Bozrah |

|Brooksvale |Cheshire |Derby |Derby |Flanders |Kent |

|Buckingham |Glastonbury |Devon |Milford |Flanders Village |East Lyme |

|Buckland |Manchester |Doaneville |Griswold |Forestville |Bristol |

|Burlington |Burlington |Dobsonville |Vernon |Fort Hill |Groton |

|Burnett Corners |Groton |Dodgingtown |Newtown |Foxon |East Haven |

|Burnside |East Hartford |Drakeville |Torrington |Franklin |Franklin |

|Communities |Towns |Communities |Towns |Communities |Towns |

| | | | | | |

|Gales Ferry |Ledyard |Hockanum |East Hartford |Marbledale |Washington |

|Gardner Lake |Bozrah |Hopewell |Glastonbury |Marion |Southington |

|Gaylordsville |New Milford |Hopeville |Griswold |Marlboro |Marlboro |

|Georgetown |Wilton |Hopeville |Waterbury |Mashapaug |Union |

|Georgetown |Weston |Hop River |Columbia |Massapeag |Montville |

|Germantown |Danbury |Hotchkissville |Woodbury |Mechanicsville |Thompson |

|Gilead |Hebron |Howard Valley |Hampton |Mechanicsville |Granby |

|Gildersleeve |Portland |Huntington |Shelton |Melrose |East Windsor |

|Gilman |Bozrah |Huntingtown |Newtown |Meriden |Meriden |

|Glasgo |Griswold |Huntsville |Canaan |Merrow |Mansfield |

|Glastonbury |Glastonbury |Hydeville |Stafford |Merwinsville |New Milford |

|Glenbrook |Stamford | | |Mianus |Greenwich |

|Glenville |Greenwich |Indian Neck |Branford |Middlebury |Middlebury |

|Goodyear |Killingly |Ivoryton |Essex |Middlefield |Middlefield |

|Goshen |Goshen | | |Middlefield Center |Middlefield |

|Goshen Hill |Lebanon |Jewett City |Griswold |Middle Haddam |East Hampton |

|Granby |Granby |Jordon Village |Waterford |Middletown |Middletown |

|Graniteville |Waterford |Judd’s Bridge |Roxbury |Milford |Milford |

|Grasemere Station |Fairfield | | |Millstone |Waterford |

|Grassy Plain |Bethel |Kensington |Berlin |Milldale |Southington |

|Greenfield |Fairfield |Kent |Kent |Millington |East Haddam |

|Greenfield Hill |Fairfield |Kent Furnace |Kent |Mill Plain |Danbury |

|Green’s Farms |Westport |Kenyonville |Woodstock |Millville |Naugatuck |

|Greenville |Norwich |Killingly |Killingly |Milton |Litchfield |

|Greystone |Plymouth |Killingly Center |Killingly |Minortown |Woodbury |

|Greenwich |Greenwich |Killingworth |Killingworth |Mixville |Cheshire |

|Griswold |Griswold |Kittemaug |Montville |Mohegan |Montville |

|Griswoldville |Wethersfield |Knollwood |Old Saybrook |Momaugin |East Haven |

|Grosvenordale |Thompson | | |Monroe |Monroe |

|Groton |Groton |Lakeside |Morris |Montowese |North Haven |

|Groton Heights |Groton |Lakeville |Salisbury |Monteville |Montville |

|Groton Long Point |Groton |Laurel Glen |North Stonington |Moodus |East Haddam |

|Grove Beach |Westbrook |Laurel Hill |Norwich |Moosup |Plainfield |

|Guilford |Guilford |Laysville |Old Lyme |Moose Meadow |Willington |

|Gurleyville |Mansfield |Lebanon |Lebanon |Morningside |Milford |

| | |Ledyard |Ledyard |Morningside Park |Waterford |

|Haddam |Haddam |Leesville |East Haddam |Morris |Morris |

|Haddam Neck |East Hampton |Leete’s Island |Guilford |Mount Carmel |Hamden |

|Hadlyme |Lyme |Leonard Bridge |Lebanon |Mount Hope |Mansfield |

|Hallsville |Willington |Liberty Hill |Lebanon |Mystic |Stonington |

|Hamburg |Lyme |Lime Rock |Salisbury |Mystic |Groton |

|Hamden |Hamden |Lisbon |Lisbon | | |

|Hammonasset Point |Madison |Litchfield |Litchfield |Naugatuck |Naugatuck |

|Hampton |Hampton |Little Haddam |East Haddam |Nepaug |new Hartford |

|Hancock |Plymouth |Long Hill |Trumbull |New Britain |New Britain |

|Hanks Hill |Mansfield |Long Neck |Darien |New Canaan |New Canaan |

|Hanover |Sprague |Long Ridge |Stamford |Newent |Lisbon |

|Harrisville |Woodstock |Long Society |Preston |New Fairfield |New Fairfield |

|Hartford |Hartford |Lords Point |Stonington |Newfield |Middletown |

|Hartland |Hartland |Lordship |Stratford |Newfield |Torrington |

|Harwinton |Harwinton |Lower City |Canaan |New Hartford |New Hartford |

|Hattertown |Newtown |Lower Merryall |New Milford |New Haven |New Haven |

|Hawleyville |Newtown |Lyme |Old Lyme |Newington |Newington |

|Hayden’s |Windsor |Lyons Plains |Weston |New London |New London |

|Hazardville |Enfield | | |New Milford |New Milford |

|Hebron |Hebron |Macedonia |Kent |New Preston |Washington |

|Higganum |Haddam |Madison |Madison |Newtown |Newtown |

|Highland |Middletown |Manchester |Manchester |Niantic |East Lyme |

|Highland Park |Manchester |Manchester Green |Manchester |Nichols |Trumbull |

|High Ridge |Stamford |Mansfield |Mansfield |Nineveh Falls |Killingworth |

|Highwood |Hamden |Mansfield Center |Mansfield |Noank |Groton |

|Hillstown |East Hartford |Mansfield Hollow |Mansfield |Norfolk |Norfolk |

|Communities |Towns |Communities |Towns |Communities |Towns |

| | | | | | |

|Noroton |Darien |Plainfield |Plainfield |Saybrook Point |Old Saybrook |

|Noroton Heights |Darien |Plainville |Plainville |Saybrook Manor |Old Saybrook |

|North Ashford |Eastford |Plantsville |Southington |Scantic |East Windsor |

|North Bloomfield |Bloomfield |Pleasant Valley |Barkhamsted |Scitico |Enfield |

|North Branford |North Branford |Plymouth |Plymouth |Scotland |Scotland |

|North Canaan |North Canaan |Pomfret |Pomfret |Seymour |Seymour |

|North Canton |Canton |Pomfret Center |Pomfret |Shailerville |Haddam |

|North Colebrook |Colebrook |Pomfret Landing |Pomfret |Sharon |Sharon |

|Northfield |Litchfield |Pomperaug |Woodbury |Shelton |Shelton |

|Northford |North Branford |Pond Meadow |Westbrook |Sherman |Sherman |

|North Cromwell |Cromwell |Ponset |Haddam |Short Beach |Branford |

|North Franklin |Franklin |Poquetanuck |Preston |Silvermine |Norwalk |

|North Granby |Granby |Poquonock |Windsor |Simsbury |Simsbury |

|North Grosvenordale |Thompson |Poquonock Bridge |Groton |Sodom |North Canaan |

|North Guilford |Guilford |Portland |Portland |Somers |Somers |

|North Haven |North Haven |Preston |Preston |Somersville |Somers |

|North Kent |Kent |Preston City |Preston |Sound Beach |Greenwich |

|North Lyme |Lyme |Prospect |Prospect |Sound View |Old Lyme |

|North Madison |Madison |Putnam |Putnam |South Britain |Southbury |

|North Norfolk |Norfolk |Putnam Heights |Putnam |Southbury |Southbury |

|North Plains |East Haddam | | |South Canaan |Canaan |

|North Somers |Somers |Quadic |Thompson |South Chaplin |Chaplin |

|North Stamford |Stamford |Quaker Farms |Oxford |Southford |Southbury |

|North Sterling |Sterling |Quaker Hill |Waterford |South Glastonbury |Glastonbury |

|North Stonington |North Stonington |Quarryville |Bolton |Southington |Southington |

|North Thompsonville |Enfield |Quinebaug |Thompson |South Kent |Kent |

|Northville |New Milford |Quinnipiac |North Haven |South Killingly |Killingly |

|North Wilton |Wilton | | |South Lyme |Old Lyme |

|North Windham |Windham |Rainbow |Windsor |South Meriden |Meriden |

|North Woodbury |Woodbury |Redding Ridge |Redding |South Norfolk |Norfolk |

|North Woodstock |Woodstock |Reeds Gap |Durham |South Norwalk |Norwalk |

|Norwalk |Norwalk |Reynolds Bridge |Thomston |Southport |Fairfield |

|Norwich |Norwich |Ridgebury |Ridgefield |South Willington |Willington |

|Norwichtown |Norwich |Ridgefield |Ridgefield |South Wilton |Wilton |

|Nut Plains |Guilford |River Bank |Stamford |South Windham |Windham |

| | |Rivercliff |Milford |South Windsor |South Windsor |

|Oakdale |Montville |Riverside |Greenwich |South Woodstock |Woodstock |

|Oakville |Watertown |Riverside |Oxford |Sprague |Sprague |

|Ocean Beach |New London |Riverton |Barkhamsted |Springdale |Stamford |

|Occum |Norwich |Robertsville |Colebrook |Spring Glen |Hamden |

|Old Greenwich |Greenwich |Rockfall |Middlefield |Spring Hill |Mansfield |

|Old Lyme |Old Lyme |Rockland |Madison |Stafford |Stafford |

|Old Mystic |Stonington |Rockville |Vernon |Stafford Springs |Stafford |

|Old Saybrook |Old Saybrook |Rocky Glen |Newtown |Staffordville |Stafford |

|Oneco |Sterling |Rocky Hill |Rocky Hill |Stamford |Stamford |

|Orange |Orange |Rogers |Killingly |Stanwich |Greenwich |

|Orcuttville |Stafford |Romford |Washington |Stepney |Monroe |

|Ore Hill |Salisbury |Roton Point |Norwalk |Sterling |Sterling |

|Oronoke |Middlebury |Round Hill |Greenwich |Sterling Hill |Sterling |

|Oronoque |Stratford |Rowayton |Norwalk |Stevenson |Monroe |

|Oxford |Oxford |Roxbury |Roxbury |Still River |New Milford |

| | |Roxbury Falls |Roxbury |Stonington |Stonington |

|Pachaug |Griswold |Roxbury Station |Roxbury |Stony Creek |Branford |

|Packerville |Canterbury | | |Storrs |Mansfield |

|Park Lane |New Milford |Sachems’ Head |Guilford |Straitsville |Naugatuck |

|Pawcatuck |Stonington |Sadds Mills |East Windsor |Stratford |Stratford |

|Pequabuck |Plymouth |Salem |Salem |Suffield |Suffield |

|Phoenixville |Eastford |Salem Four Corners |Salem | | |

|Pines Bridge |Beacon Falls |Salisbury |Salisbury |Taconic |Salisbury |

|Pine Meado |New Hartford |Sandy Hook |Newtown |Taftville |Norwich |

|Pine Orchard |Branford |Saugatuck |Westport |Talcottville |Vernon |

|Pleasure Beach |New London |Savin Rock |West Haven |Tariffvile |Simsbury |

| | | | | | |

|Communities |Towns |Communities |Towns | | |

| | | | | | |

|Terryville |Plymouth |West Haven |West Haven | | |

|Thamesville |Norwich |Westminster |Canterbury | | |

|Thomaston |Thomaston |West Mystic |Groton | | |

|Thompson |Thompson |West Norfolk |Norfolk | | |

|Thompsonville |Enfield |West Norwalk |Norwalk | | |

|Titicus |Ridgefield |Weston |Weston | | |

|Tokeneke |Darien |Westport |Westport | | |

|Tolland |Tolland |West Redding |Redding | | |

|Tolles |Plymouth |West Simsbury |Simsbury | | |

|Topstone |Redding |West Stafford |Stafford | | |

|Torringford |Torrington |West Stratford |Stratford | | |

|Torrington |Torrington |West Suffield |Suffield | | |

|Totoket |North Branford |West Thompson |Thompson | | |

|Towantic |Oxford |West Torrington |Torrington | | |

|Tracy |Wallingford |Westville |New Haven | | |

|Trumbull |Trumbull |West Willington |Willington | | |

|Turn of River |Stamford |West Woodstock |Woodstock | | |

|Twin Lakes |Salisbury |Wethersfield |Wethersfield | | |

|Tyler City |Orange |Whigville |Burlington | | |

|Tylerville |Haddam |White Oaks |Southbury | | |

| | |Whitneyville |Hamden | | |

|Uncasville |Montville |Willimantic |Windham | | |

|Union |Union |Willington |Willington | | |

|Union City |Naugatuck |Wilson |Windsor | | |

|Unionville |Farmington |Wilson’s Point |Norwalk | | |

|Upper Merryall |New Milford |Wilsonville |Thompson | | |

|Upper Stepney |Monroe |Wilton |Wilton | | |

| | |Winchester |Winchester | | |

|Vernon |Vernon |Winchester Center |Winchester | | |

|Vernon Center |Vernon |Windemere |Ellington | | |

|Versailles |Sprague |Windham |Windham | | |

|Village Hill |Stafford |Windsor |Windsor | | |

|Voluntown |Voluntown |Windsor Locks |Windsor Locks | | |

| | |Windsorville |East Windsor | | |

|Wallingford |Wallingford |Winnipauk |Norwalk | | |

|Walnut Beach |Milford |Winsted |Winchester | | |

|Wapping |South Windsor |Winthrop |Deep River | | |

|Warehouse Point |East Windsor |Wolcott |Wolcott | | |

|Warren |Warren |Woodbridge |Woodbridge | | |

|Warrenville |Ashford |Woodbury |Woodbury | | |

|Washington |Washington |Woodmont |Milford | | |

|Washington Depot |Washington |Woodstock |Woodstock | | |

|Waterbury |Waterbury |Woodstock Valley |Woodstock | | |

|Waterford |Waterford |Woodville |Washington | | |

|Watertown |Watertown |Wrightville |Torrington | | |

|Waterville |Waterbury | | | | |

|Wauregan |Plainfield |Yalesville |Wallingford | | |

|Weatogue |Simsbury |Yantic |Norwich | | |

|Wellsville |New Milford | | | | |

|Wequetequock |Stonington |Zoar Bridge |Oxford | | |

|West Ashford |Ashford | | | | |

|West Avon |Avon | | | | |

|Westbrook |Westbrook | | | | |

|Westchester |Colchester | | | | |

|West Cornwall |Cornwall | | | | |

|Westfield |Middletown | | | | |

|Westford |Ashford | | | | |

|West Goshen |Goshen | | | | |

|West Granby |Granby | | | | |

|West Hartford |West Hartford | | | | |

|West Hartland |Hartland | | | | |

LABORATORY REPORTABLE SIGNIFICANT FINDINGS – 2006

|Physician's Report of Occupational Disease |

|Connecticut Departments of Labor and Public Health |

|This information is reportable by law within forty-eight (48) hours under CGS Sec.31-40a |

|Date of Report:______/______/______ and confidential under CGS I-19(b)(2) and 19a-25 |

|please type or write clearly |

I. Patient (Employee) Information

Name:_______________________________________________________________________________________________________SSN:________/________/________

Last First MI

Address: __________________________________________________________________________________________________________________________________

Street City State Zip Code

Home Phone #: ( ) ________-________ Date of Birth: _____/_____/_____ Gender: ( Male ( Female

Hispanic: ( Yes ( No ( Unknown Race: ( American Indian ( Asian ( Black ( White ( Other ( Unknown

Occupation (at time of exposure)__________________________________________________(present)______________________________________________________

II. Occupational Illness/Injury Information (ICD-9)

|Repetitive Trauma Disorders |Respiratory Diseases/Disorders |Poisonings and toxic effects |

|( Carpal Tunnel Syndrome (354.0) |( Allergic Rhinitis (477) |( Carbon Monoxide (986) |

|( DeQuervains Syndrome (727.04) |( Asbestosis (501) |( Lead (984) _______(g/dL (Attach copy of lab report) |

|( Epicondylitis (Tennis Elbow) (726.32) |( Asthma (493) |( Solvents (982) |

|( Hand-Arm Vibration Syndrome (443.0) |( Bronchitis (491) |( Cancer (type)_________________________( ) |

|( Raynaud’s Syndrome (443.0) |( Pleural Plaques (511.0) |( OTHER (specify)______________________( ) |

|( Thoracic Outlet Syndrome (353.0) |( Reactive Airway Dysfunction Syndrome (506) | |

|( Trigger Finger (727.03) |( Rhinitis (472.0) |Noise Disorders |

|( Vibration White Finger (443.0) |( Silicosis (502) |( Hearing Loss (389) |

|( Bursitis (site) _______________________ (727.3) |( Sinusitis (473) |( Tinnitis (388.3) |

|( Ganglion/ Cystic Tumor (site)__________ (727.4) |( OTHER (specify)___________________( ) |( OTHER (specify)______________________( ) |

|( Synovitis (site)______________________ (727.0) | | |

|( Tendonitis (site)____________________ (726.90) |Infectious Processes |Skin Diseases/Disorders |

|( Tenosynovitis (site)__________________ (727.0) |( Hepatitis B (070.3) |( Contact Dermatitis (692) |

|( OTHER (specify)___________________ ( ) |( Tuberculin conversion (010) |( OTHER (specify)______________________( ) |

| |( OTHER (specify)___________________( ) | |

| | |( Injury (specify type and site on diagnosis line below) |

Diagnosis (if not listed above):___________________________________________________________________________________ICD-9(s) ___________________

Symptoms/Physical Findings:__________________________________________________________________________________Date of First Symptom:____/____/____

Suspected causal factor(s) (i.e., object, substance or event):__________________________________________________________________________________________

Exposure: ( Acute ( Chronic Is patient exposure continuing? ( Yes ( No ( Unknown Are others likely to be affected? ( Yes ( No ( Unknown

Certainty of work relatedness: ( High ( Moderate ( Low Length of employment in occupation of concern: ________yrs_______months

Comments:________________________________________________________________________________________________________________________________

III. Employer Information (where exposure occurred)

Company Name:____________________________________________________________________________________________________________________________

Mailing Address:____________________________________________________________________________________________________________________________

Street City State Zip Code

Phone #: ( ) ________-_________ Work site location (if different than above)____________________________________________________________________

IV. Health Care Provider Information

Name:____________________________________________________________________________________________________________________________________

Last First MI (MD, RN, PA, Other)

Institution/Clinic name:______________________________________________________________________________________________________________________

Mailing Address:___________________________________________________________________________________________________________________________

Street City State Zip Code

Phone #: ( ) ________-_________ Signature:___________________________________________________________________

For more information call: (860) 566-4550 Labor Department or (860) 509-7744 Department of Public Health

Return to: State of Connecticut Labor Department, Division of Occupational Safety & Health, 38 Wolcott Hill Rd., Wethersfield, CT 06109

For office use only

Rev. 10/95 |ID No.

|OC exp

|OC present

|Nature

|POB

|SIC | |

-----------------------

[pic]

The director of any clinical laboratory must report any laboratory evidence suggestive of reportable diseases. A standard form, known as the Laboratory Report of Significant Findings (OL-15C) is available for reporting these laboratory findings and can be obtained from the Connecticut Department of Public Health, Epidemiology Program, 410 Capitol Ave., MS#11EPI, P.O. Box 340308, Hartford, CT 06134-0308; telephone: (860-509-7994). The laboratory reports are not substitutes for physician reports; they are supplements to physician reports which allow verification of diagnosis. A listing of diseases indicative of possible bioterrorism is highlighted at the end of this list. Changes for 2006 are noted in bold and with an asterisk (*).

AIDS (report only to the State)

• CD4+ T-lymphocyte counts 9%: ___________% COHb

Chancroid

Chickenpox, acute: θIgM θCulture θPCR

θDFA θOther: _______________

Chlamydia (C. trachomatis) (test type: ______________)

Creutzfeldt-Jakob disease, age < 55 years (biopsy)

Cryptosporidiosis (method of ID) __________________

Cyclosporiasis (method of ID) ____________________

Diphtheria (1)

Ehrlichiosis (2) θHGE θHME θUnspecified

θIFA θBlood smear θPCR θOther: _________

Encephalitis:

California group virus (species) ____________________

Eastern equine encephalitis virus

St. Louis encephalitis virus

West Nile virus infection – human or animal

Other arbovirus (specify) ________________________

Enterococcal infection, vancomycin-resistant (2,3)_________

Escherichia coli O157 infection (1)

Giardiasis

Gonorrhea (test type: _____________________________)

Group A streptococcal disease, invasive (3)

Group B streptococcal disease, invasive (3)

Haemophilus influenzae disease, invasive, all serotypes (1,3)

Hansen’s disease (Leprosy)

Hepatitis A θ IgM anti-HAV (1)*

Hepatitis B θ HBsAg θ IgM anti-HBc

Hepatitis C (anti-HCV) Ratio: _______ θRIBA θPCR (4)

Hepatitis Delta θHDAg, θ IgM anti-HD

HIV Infection (report only to the State) (1)

• HIV-1 infection in persons of all ages (5)(6)*

Influenza: θ A θ B θ Unk.

θ RT-PCR θ Culture θ Rapid test

Lead Poisoning (blood lead > 10 µg/dL)

θ Finger Stick: ______ µg/dL θ Venous: ______ µg/dL

Legionellosis

θ Culture θ DFA θ Ag positive

θ Four-fold serologic change (titers): _______________

Listeriosis (1)

Lymphocytic choriomeningitis virus infection*

Malaria/blood parasites (1,2) : ________________________

Measles (Rubeola) (titer) (7): _________________________

Meningococcal disease, invasive (1,3)

Mercury poisoning

θ Urine > 35 µg/g creatinine ___________________ µg/g

θ Blood > 15 µg/L ______________________ µg/L

Mumps (titer): __________________

Neonatal bacterial sepsis (9) spp _________________

Pertussis (titer): _________________

DFA Smear: θ Positive θ Negative

Culture: θ Positive θ Negative

Pneumococcal disease, invasive (1,3)

Oxacillin disk zone size: _________ mm

MIC to penicillin: _______________ µg/mL

Poliomyelitis

Rabies

Rocky Mountain spotted fever

Rubella (titer): __________________

Salmonellosis (1,2) (serogroup/serotype) ________________

SARS-CoV infection (10) θ IgM/IgG

θ PCR _______ (specimen) θ Other _____________

Shiga toxin-related disease (1)

Shigellosis (1,2) (serogroup/species) ____________________

Staphylococcus aureus infection with MIC to

vancomycin > 4 µg/mL (1)

MIC to vancomycin: __________ µg/mL

Staphylococcus aureus disease, invasive (3)

methicillin-resistant Date pt. Admitted _____/_____/______

Staphylococcus epidermidis infection with MIC to

vancomycin > 4 µg/mL (1)

MIC to vancomycin: __________ µg/mL

Syphilis θ RPR (titer): ______ θ FTA (titer): ________

θ VDRL (titer): _____ θ MHA (titer): _______

Trichinosis

Tuberculosis (1)

Specimen type: ________________________________

AFB Smear: θ Positive θ Negative

If positive: θ Rare θ Few θ Numerous

Culture: θ Mycobacterium tuberculosis only

θ Other mycobacterium (specify: M. ____________)

Typhus

Vibrio infection (11)* (species) ________________________

Yellow fever

Yersiniosis (species) ______________________________

Diseases that are possible indicators of bioterrorism (8)

Anthrax (1)

Botulism

Brucellosis (1)

Gram positive rods in blood or CSF, growth within 32 hours

of inoculation (specify:______________)

Plague (1)

Q fever

Ricin poisoning

Smallpox (1)

Staphylococcal enterotoxin B pulmonary poisoning

Tularemia

Venezuelan equine encephalitis

Viral hemorrhagic fever

(1) Send isolate, culture, or slide to the State Laboratory for confirmation. For Shiga-toxin, send broth culture from which positive Shiga-toxin test was made. For HIV and hepatitis A, send > 0.5 mL residual serum to the State Laboratory.

(2) Specify species/serogroup.

(3) Sterile site isolates. Sterile site defined as blood, CSF, pericardial fluid, pleural fluid, peritoneal fluid, joint fluid, bone, internal body site (lymph node, brain, heart, liver, spleen, kidney, pancreas, or ovary), vitreous fluid, or other normally sterile site; includes muscle for invasive group A streptococcal disease.

(4) Report all positive anti-HCV with signal to cutoff ratio, all positive RIBA, but only confirmatory PCR tests.

(5) Report any tests indicative of HIV infection including antibody, antigen, PCR-based and viral load tests with name and street address.

(6) Report all HIV viral load test results, including those with no virus detectable, with name and street address.

(7) Report all IgM titers, but only IgG titers that are considered significant by the laboratory performing the test.

(8) Report by telephone to the Department of Public Health, weekdays 860-509-7994; weekends and evenings 860-509-8000.

(9) Report all bacterial isolates from blood or CSF obtained from an infant ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download