Smoking 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.

Name
Email*
Phone Number
Complaint Location
Establishment Name
Address 1
Address 2
City
State
Zip Code
Date of Violation
MM slash DD slash YYYY
Time of Violation
Please explain your complaint*
By clicking submit you agree that CCDPH may disclose the information contain in this form to other entities that may be able to assist you or to other authorities that may have jurisdiction over this issue.
CAPTCHA

File a Complaint

Updated August 10, 2020, 2:27 PM