Health Officer Complaint Form

Please complete the form below to initiate a complaint.  Please include all requested information, including name, phone number, and e-mail address.  If this is an emergency situation (sick or ill subjects), please call 911 and have an ambulance respond. 

Thank you.


Best Phone Number Complainant can be reached
Street Address, Town, State & Zip Code
Full email address for Complainant
Please provide a detailed description of your complaint.
Provide Location of Property, even if it is the same address of complainant. If it is not property related, please note in this section.
Provide any information that would be helpful to assist in the resolution of your complaint.