2. Complete this form to ask a question about our PPA Program or to request technical assistance visit from the Whatcom County Health and Community Services Environmental Health Division.

   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 length of the queue, 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. 1a. First Name*
5. 1b. Last Name*
7. 2. Business Name*
9. 3. Phone Number*
11. 4. Please Describe Your Need*
15. Business Address*
17. City*
18. State*
19. Zip*
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit Submit and Print

* indicates a required field