New Nuisance Complaint Form

Nuisances / Housing

You may submit a paper form by mail or e-mail to the Sidney-Shelby County Health Department.   See Public Health Nuisance Form

Nuisance Complaint Form

Location of Complaint:

 

 

 

 

Maximum file size: 6MB

Maximum file size: 6MB

 

 

Please provide the best day(s) and time(s) you're available for us to contact you:

Monday
Tuesday
Wednesday
Thursday
Friday
 

 

Your contact information:

Name
Name
First Name
Last Name
Are you a tenant living at this property?

Please note:

****All information on this form is considered public information and subject to review or release to any requesting party.
***Anonymous public health nuisance complaints will not be accepted. Form must be filled out completely to be accepted.

Check Box: