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HANDS Information/Enrollment

Please Check All That Apply*

First Time Mom

First Tim Dad

Multigravida (given birth more than once)

Mom's Name*

Dad's Name

Mom's Date of Birth*

Month

Day

Year

Due Date/Birth Date*

Month

Day

Year

Phone*

Alternate Phone

Can we send text messages to your phone?*

Yes

No

Email

Street Address*

City*

County*

State*

Zip Code*

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contactbchd@bullitthealth.org

502-543-2415 or 502-955-7837

181 Lees Valley Road

Shepherdsville, KY 40165

Monday

Tuesday
Wednesday
Thursday

Friday

7:30 AM - 4:30 PM

7:30 AM - 6:30 PM

7:30 AM - 4:30 PM

7:30 AM - 4:30 PM

7;30 AM - 11:00 AM

*Environmental hours

© 2023 by Bullitt County Health Department

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