The below referral forms and programs are available to assist health care providers.
Please call the St. Mary’s County Health Department at (301) 475-4330 during business hours for more information or guidance.
For urgent public health situations after business hours, please call the St. Mary’s County Emergency Operations Center at (301) 475-8016 to be connected to a public health official on-call.
Referral Forms for Department Services
- Report a Possible Animal Bite or Exposure (Note: Health care providers are required by state law to report animal bites or scratches) – Call the Health Department at (301) 475-4330 and submit Maryland State Form #4206 to the St. Mary’s County Health Department
- Disease Reporting – Call the SMC Health Department at (301) 475-4330 and submit Maryland State Form #1140 to the St. Mary’s County Health Department
- Chronic Disease Self-Management Program Referral Form
- Infants and Toddlers Program Referral Form
- Cancer Screening, Diagnosis, and Treatment (For eligible residents in need of breast, cervical, or colorectal cancer screening services)
- Resource Coordination Program (services to support individuals with disabilities)
- Adult Evaluation and Review Services (AERS) (For adults over the age of 22 who are aged or have a functional disability, and may be in need of long term care services)
- Perinatal Risk Assessment Form (For health dept assistance with very high risk pregnancies)
- Postpartum Infant and Maternal Referral Form (For health dept assistance with very high risk infants and mothers)
- Asthma Control Program Home Visit (For children with asthma – free home visit for environmental trigger reduction and asthma education)