File a Public Health Complaint

Please Submit Your Public Health Complaint Below

Complaint

Disclaimer: You may call the Health Department at 885-1863 to file a complaint instead of completing this form.

Your Name (required)

Date (required)

Time (required)

Telephone (required)

Your Email

Name of Establishment (if applicable)

Address of Complaint

Location of Complaint

Responsible Party Name

Responsible Party Address

Subject
Public Health Complaint

Your Message