New Milford Health Department
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Complaints

Complaint Form

Please fill out the form as completely as possible.  You may submit the form as anonymous.  If  you do, please note that any form with incomplete information or contact information may cause difficulty to follow up.  If you have any questions, please feel free to contact the Health Department at 860-355-6035
Date: *
 Time:  
  Complaintant Information 
 Your name:
(You may enter Anonymous) *		  
 Your contact information:
(Either phone or email)		  
  Complaint Information 
 Address of complaint: *  
 Owner's name:
(If known)		  
 Owner's contact information:
(Phone number prefered or e-mail)		  
 Complaint:
(Please be as detailed as possible) *		  
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