Forsyth County Department of Public Health Fee Schedule ...

Forsyth County Department of Public Health Fee Schedule 2020-2021

All prices are per each dose and apply to all Adults and to those Children who are fully Insured:

Vaccine

Number of Doses Cost per Dose*

DTaP (Child)

5-dose series

$32

Gardasil (HPV) (Adult or Child)

3-dose series

$321

Hepatitis A (Adult)

2-dose series

$46

Hepatitis A (Child)

2-dose series

$32

Hepatitis A & B Combined (Twinrix) (Adult)

3-dose series

$111

Hepatitis B (Adult)

3-dose series

$54

Hepatitis B (Adult) (Heplisav-B)

2- dose series

$118

Hepatitis B (Child)

3-dose series

$36

HIB (Haemophilus Influenzae B) (Adult or Child)

1 dose

$31

Inactivated Polio (Adult or Child)

1 dose

$38

Meningococcal B (Adult or Child) Bexsero

2-dose series

$183

Meningococcal ACWY(Adult or Child) Menactra

2-dose series

$158

Measles, Mumps, Rubella (MMR) (Adult or Child)

1 or 2 doses

$92

Pneumococcal Conjugate (Prevnar13) (Child)

4-dose series

$266

Pneumococcal (PPSV 23) (Adult)

1 dose

$124

Td (Adult or Child)

Up to 3 doses

$39

Tdap (Adult or Child)

1 dose

$41

Varicella (Chickenpox) (Adult or Child)

2-dose series

$162

Shingrix (Shingles) (Adult)

2-dose series

$173

PPD Skin Test Placement

1 dose

$25

PPD Skin Test Reading Placed Elsewhere

$10

I-693 GreenCard Application

Application only

$30

* Administration fee for the first vaccine is $30, each additional vaccine administration is $18

*Please note: vaccines may not be available at all times*

Medical Records

1-25 pages (cost is per page)

26-100 pages (cost is per page)

100+ pages (cost is per page)

ChildBirth Classes

Childbirth Classes

Environmental Health

SSA Soil Site Application: any 3,4,5 or 6 BR house _SS_1__4_8_0_-1_l5o0t0s@gp_d__(b_u_s_i/nloests or church) SS2 1500-3000 gpd SS3 >3000 gpd REV Revisit RED Redraw IP/CA LLP LLP System TPN T & J Panel New CGN Conventional or Alter., Gravity, new CGR Conv. or Alter., Grav., T&J Panel Rpr PMP Any Pump installation (new only) MHP Mobile Home Conn. In Existing Park HDR Health Dept. Release WCP Water Supply Well Const. NFHC Permit DCP Drinking Water Well Const. Permit WAB Well Abandonment WSB Water Sample, Bacteria WSF Water Sample Fluoride WSI Water Sample Inorganic WSN Water Sample Nitrate/Nitrite WSP Water Sample Pesticide WSL Water Sample Petroleum

Cost

$0.75 $0.50 $0.25

$17.38

$204.00 $432.00 $654.00 $2,306.00

$56.00 $38.00 $320.00 $308.00 $234.00 $204.00 $62.00 $117.00 $56.00 $352.00 $432.00 $155.00 $45.00 $47.00 $89.00 $47.00 $106.00 $106.00

WSO Water Sample Organic (VOA) WSU Water Sample Uranium (plus three metals) WIB Water Sample Iron Reducing Bacteria WSR Water Sample Sulfate Reducing Bacteria WIN Water Supply Inorganic and Nitrate SAF Swimming Pool Annual Fee SSP Secondary Pool at Same Site SPR Swimming Pool Plan Review SPRF Swimming Pool Revisit Fee (new) FSR Food Service Plan Review FRP Foodservice Remodel, Plan Review MFU Plan Review PushCart Plan review TAP Tattoo Artist Annual Permit Fee *TEW Tattoo/Permanent Makeup Artist Educational Workshop Fee Up to 4*TSEtSudTeantttoso/Permanent Makeup Artist Educational Workshop Fee For ESAacPhSEenarfoololeddMAkrttiAstnbneuyaol nPder4mit Fee TFE Temporary Food Establishment Fee * A Tattoo/Permanent Makeup Artist Educational Workshop is a course of iLnDsStrDuuctsitoSnafmorptleat(tEoaoc/hp)e2r4mHanoeunr tTmurankAeuropuanrdtists which will last no longer tLhSaSnSo5ildSaayms aptleo(nEealcohc)a2t4ioHnoaunrdTfuorrnwAhriocuhnndo fee is charged to apply a tfLeaPetStosPhoaaionllrtbpCeeh$rimp10Sa0anmefonprtletmh(eaEkainecushtp)ru2t4cotHoaropauanrtrdTouunrp,nmtAoor4odeuslntuoddr ecnutsst.oTmheer.pTehrme ibtafseee fLoWr SeaLcehadadindiDtiroinnkailnsgtuWdaetnetra(nEda/cohr) i9n6stHruocutroTrubrenyAornodutnhde first 4 artists will bLWe $S2L6e.a0d0 ienaDchri.nking Water (Each) 48 Hour Turn Around LWS Lead in Drinking Water (Each) 24 Hour Turn Around Comprehensive Environmental Lead Investigation, Not Including LFaobr oardadtoitriyonAanlaiynsfiosr, mPeartiDown:elling Family Planning Forsyth County Dental Clinic (Cleveland) Environmental Health Immunizations

$106.00 $90.00 $76.00 $84.00 $95.00

$130.00 $32.00

$250.00 $56.00

$246.00 $123.00 $150.00 $100.00 $123.00 $123.00

$31.00 $0.00

$75.00

$120.00

$0.00 $10.20

$8.20 $31.00 $42.00 $73.00

$1,200

336-703-3291 336-703-3090 336-703-3325 336-703-3114

Effective September 1, 2020

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