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Permitted Facility Complaint Form

"*" indicates required fields

Disclosure: Contact information is always confidential and never disclosed to the establishment. It is only used for our sanitarians to contact you to gather additional information.
Contact
Name
Would you like to be contacted?
Establishment details (Required)
MM slash DD slash YYYY
Time of Incident*
:
Did you notify the establishment about your complaint?
If available, please include a photo or video when submitting your complaint. Upload it below.
Max. file size: 512 MB.
Upload Photo
Accepted file types: jpg, jpeg, png, gif.
Call 262-636-9203 for further assistance
Click "Submit" once Any information you provide on this form may be subject to disclosure under Wisconsin’s Public Records laws, in accordance with Wis. Stats. §§ 19.31-19.39.
This field is for validation purposes and should be left unchanged.
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