Environmental Services Complaint Form

Environmental Services Complaint Form

Use this form to file a complaint with Environmental Health at the Webster County Health Unit. Submitted forms are secure and may remain anonymous.
Date & Time Event Occurred

MonthDayYear
Date
Hour MinutesAM/PM Option
Type of Complaint:

FoodSewageOther
Complaint Filed Upon:
Facility or Homeowners Name
Location/Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (if known):
Please enter a valid phone number.
Directions to the site from Marshfield:
Nature of the complaint:
Please provide a detailed description of your complaint.
Additional Comments
Complainant's Name:*
First & Last Name
Remain anonymous?

YesNo
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Your contact information will be kept confidential. It will only be used for the purpose of addressing your complaint and, if necessary, for follow-up communication.
What Happens Next:
- Our health unit team will review your submission and conduct a thorough investigation.
- We will take appropriate actions to address the reported concern and ensure public health and safety.
- You may be contacted for additional information if necessary.
Thank you for helping us maintain a safe and healthy community!
Should be Empty: