Lenawee County, MI · Lenawee County
Health Department Complaint Form
Lenawee County residents can use this form to report property-related health concerns to the Lenawee County Health Department.
At a glance
- Issued by
- City of Lenawee County · Lenawee County, Lenawee County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- lenawee.mi.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The form records where a complaint is located, the property owner’s contact details, the type of concern, and when the violation was observed. The Health Department accepts complaints about water supply, sewage disposal, housing, garbage, pests, chemicals, hazardous waste, food service, and other issues. Food service complaints may be anonymous; other complaints must include the complainant’s name, address, and phone number.
Who needs it
People reporting a health or environmental concern at a property in Lenawee County can complete and submit this form to the Health Department.
How to submit it
Email the completed form to [email protected], fax it to 517-264-0790, mail it to Lenawee County Health Department, 1040 S. Winter St., Suite 2328, Adrian, MI 49221, or deliver it in person.
About notarization
This complaint form does not require notarization; provide the complainant’s name and date, and the document lists no sworn attachment.
How to submit this form
- 1
Download the Form
Download the Lenawee County Health Department Complaint Form.
- 2
Complete the Form
Enter the property location and owner information, complaint type and description, observed date and time, and complainant contact details as required.
- 3
Gather Attachments
Attach an additional page if you need more space to describe the complaint.
- 4
Submit to the County
Email, fax, mail, or deliver the completed form to the Lenawee County Health Department using the details provided.
Frequently asked questions
- Do I need a notary for the Health Department Complaint Form?
- No. This complaint form does not require notarization; provide the complainant’s name and date, and the document lists no sworn attachment.
- How do I submit the complaint form?
- Email it to [email protected], fax it to 517-264-0790, mail it to the Health Department’s Adrian address, or deliver it in person.
- Can I submit a complaint anonymously?
- Only food service complaints may be anonymous. All other complaints must include the complainant’s name, address, and phone number.