TITLE 12. HEALTH
TITLE 12. HEALTH
STATE BOARD OF HEALTH
Forms
REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, General Assembly Building, 201 North Ninth Street, Fourth Floor, Richmond, Virginia 23219.
Title of Regulation: 12VAC5-421. Food Regulations.
Agency Contact: Whitney Wright, Environmental Health Coordinator, Office of Environmental Health Services, Virginia Department of Health, 109 Governor Street, Richmond, VA 23219, telephone (805) 441-1666, or email whitney.wright@vdh.virginia.gov.
FORMS (12VAC5-421)
Food Establishment Inspection Report Form - Cover Page (rev. 1/2019)
Food Establishment Inspection Report Form - Narrative (rev. 2/2020)
Food Establishment Inspection Report Form - Narrative with Temperatures (rev. 9/2017)
Food Establishment Permit Application Form (eff. 10/2026)
VA.R. Doc. No. R27-8815; Filed October 06, 2026