Please enter your contact information and the nature of your complaint, and one of our specialist will contact you as soon as possible. Note, you may submit an anonymous complaint by leaving the contact information blank, however, please fill out the form as completely as possible.

Your Name:
Your Address:
Your Daytime Telephone (xxx-xxx-xxxx):
Email Address:
Type of Complaint:	Type of Complaint Retail Food Business – restaurant / market Smoke Free Public Swimming Pool or Spa Private Swimming Pool Medical Waste Animal Bite Rats Mosquitoes Other
Location of Complaint:
	Address
	City
	Zip Code
	Enter cross street below or select area of town from dropdown menu if exact address unknown or not applicable: Downtown-Metro North Side East Side South Side West Side Northeast Northwest Southeast Southwest
	Business or Owner Name (if applicable)
	Business or Owner Address
	Business or Owner Telephone (xxx-xxx-xxxx)

Explanation of Complaint Please be as specific as possible