Clone of Lodging Complaints

Taney County Health Department
Food Concerns
To file a complaint concerning a grocery store, restaurant, or other food service establishment, please provide sufficient information below. Information needed may include the name and address of the establishment, when the item was purchased or consumed, and or the general nature of your concern or what the problem was. Please provide contact information incase our investigators have additional questions.

If you suspect that you have eaten a food that may have made you sick, to file a complaint, please provide sufficient information below. Information needed may include the name of the food, the lot number, the name and address of the establishment, when the item was purchased or consumed, and or the general nature of your concern or what the problem was. Please provide contact information incase our investigators have additional questions.
Establishment Name (Missouri establishments only):*
Establishment Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date You Visited the Establishment*

MonthDayYear
Date
Nature of Complaint/Concern:*
Do you want to remain anonymous?*

YesNo
If you select Yes, you will remain publicly anonymous, however we still need you to provide contact information incase our investigators have additional questions.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
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