2. Complete this form to file a non-emergency public health complaint or ask a question to the Whatcom County Health and Community Services.

   If this is an emergency, please call 911. Do not use this form for emergencies.

   We review submissions Monday-Friday, 8am-4pm except on legal holidays. Depending on the complexity of your question, it may take us three to five business days to respond to you.

   Disclaimer: Information submitted on this form will be sent via email. To protect sensitive information, do not provide the following information in your submission: Social Security number, driver’s license number, bank account information, routing numbers, medical information, passport numbers or passwords.

4. 1. Choose a category that best fits your question or concern.*
   -- Select One --Food – Illness ComplaintFood – Unsanitary Food EstablishmentGarbage – Garbage/Illegal DumpingPools – Complaint About PoolsRV Parks - Complaint About RV ParksSchools – Complaint About SchoolsSewage – Sewage System Failing / Sewage on the Ground / Illegal Installation of Sewage SystemSite Hazard – Potential Site Contamination – Including Illegal Drugs Like Meth or FentanylSmoking – Indoor / Outdoor Smoking ComplaintWaste – Garbage / Rats / Pet Waste on GroundWater – Complaints About Drinking WaterOther/Unsure
6. 2. Tell us about your question or concern. Please be as detailed as possible.*
8. 2b. Upload a Photo (Not Required).
10. 3. Restaurant Name.*
12. 4a. Restaurant Address*
13. 4b. City.*
15. 5. Number of persons in party (including yourself).*
17. 6. Number of ill persons in party (including yourself).*
19. 7. Suspected Food.*
21. 8. Consumption Date*
    8. Consumption Date
23. 9. Illness Start Date*
    9. Illness Start Date
25. 3a. Address/Location of Issue.*
26. 3b. City.*
28. 4a. Do you need to specify a location at the address above? (e.g., front yard, behind barn, etc.)*
    -- Select One --YesNo
30. 4b. Specify location of issue at specified address.*
34. Contact Information
36. First Name*
37. Last Name*
39. Phone Number*
40. Email*
42. Address Line 1
44. Address Line 2
46. City
47. State
48. Zip
50. How would you like to be contacted regarding your question or concern?*

    Please note, some situations may not require follow up.

    1. Email
    2. Phone
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit Submit and Print

* indicates a required field