Concern or Compliment

Taney County Health Department
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Do you want to remain anonymous*

YesNo
NOTE*: If you select Yes, you will remain publicly anonymous, however we still need you to provide contact information incase our team has additional questions.
Nature of Complaint/Concern:*
Should be Empty: