Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Report a Public Health Problem or Concern

  1. Use this form to report a public health problem such as health violations related to a restaurant, licensed childcare, pool/spa, or tattooing facility, sewage or chemical spills, waste issues, indoor/outdoor air quality problems, water problems, or animals bites. The location of the problem must be within Adams, Arapahoe, or Douglas Counties.

    Submissions to this web form are only monitored during normal business hours, Monday through Friday, 8 a.m. to 5 p.m. (excluding holidays).

    *Important Note: We highly encourage you to provide accurate contact information should questions arise. Anonymous submissions or submissions with fake contact information will not be investigated unless we determine an imminent public health threat is indicated.  

    The Tri-County Health Department will dissolve completely as of December 31, 2022. On January 1, 2023, Arapahoe, Adams and Douglas Counties will provide public health services through their own, individually operated health departments. 

    Douglas County resident only:  Effective September 1, 2022, the newly created Douglas County Health Department will assume responsibility for all Environmental Health services in Douglas County.   Starting September 1, 2022 please direct all questions/concerns related to Environmental Health to the Douglas County Health Department by calling 720 643 2400 or by visiting:

  2. Contact Information
  3. Indicate the area of your problem by checking the appropriate box(es) below:*
  4. County of Problem*
  5. Leave This Blank:

  6. This field is not part of the form submission.