Complaint form

This form can be used to file a complaint on an issue that you would like the Department of Environmental Health to investigate.

**If you would like follow-up on your complaint please provide an email or phone number that we may use to contact you.  Any personal contact information provided is kept confidential.

If you need immediate assisstance or would like to follow up on a prior complaint submittal please go to our office locations page and contact the office nearest you.

Note to users with Internet Explorer 9.0.  If you experience problems submitting your complaint, the problem may be related to an incompatible browser add-on or extension.

Type of Complaint:*
Business Name if Applicable:
Address and/or Location:*
Date of Occurrence:*
Time of Occurrence:
Your Name:*
Your E-Mail:*
Your Phone Number:*
Complaint Details:*
Please type in the code*
All fields marked with an asterisk (*) are mandatory.