COVID ill Employees for Food Establishments and Food Manufacturing Plants Complaint Form

The Cook County Department of Public Health responds to complaints within various areas of suburban Cook County and the unincorporated areas of Cook County (excluding Chicago, Oak Park, Stickney Township, Evanston and Skokie). Please fill out the form below and our staff will contact you.

Reporting Party Information
Reporting Party Name*
Reporting Party Email*
Phone number where reporting party can be reached during business hours (8:30 a.m. and 4:30 p.m.)*
Establishment/Manufacturer Information
Establishment/Manufacturer Name*
Owner/Manager Name
Owner/Manager Email
Owner/Manager Phone number
Address or intersection of Establishment/Manufacturer
Address 1*
Address 2
City
State
Zip code
Date
MM slash DD slash YYYY
Please explain your complaint*
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COVID ill Employees for Food Establishments and Food Manufacturing Plants Complaint Form

Reporting Party Information

Establishment/Manufacturer Information

File a Complaint