Allegan County

Allegan County Health Department Food Service Complaint

Submittal Date:12/13/2018 5:16:08 PM

COMPLAINANT INFORMATION:

Name:
Address:
Email:
Phone:###-###-####

ESTABLISHMENT INFORMATION:

Name:
Location:
(Street & City)
Specifics of complaint, including date:

NOTE: If this is a Food Borne Illness Complaint, PLEASE call the Health Department directly at 269-686-4534.