Pierce County Health Department Food and Recreational Facility Complaint Form
If you would like to file a complaint against one of the facilities licensed by our staff (restaurant, convenience store, grocery store, campground, rec/ed camp, body art, public pool, hotel, motel), please fill out the form below.  

Please provide as much information as possible.  You do have the option to remain anonymous; however, if you do not complete all fields, we will not be able to contact you for more information about the complaint.

This complaint and the information you provide will be used in efforts to resolve the issue and will typically be shared with the party complained against.  It may also be used to enforce applicable laws.  Under Wisconsin's Open Records Law, this complaint will be available for public view upon request after department's action is completed.  

​Complaints are generally investigated within 10 business​ days of receipt.  If you do not provide contact information, you will not be informed of the outcome.  

Forms for Landlord/Tenant Complaints and Human Health Hazard/Nuisance Complaints can be found on the Pierce County Website.  
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Establishment Name
Establishment Address (please include city/town/village)
Date of Incident
MM
/
DD
/
YYYY
Approximate Time of Incident
Description of the Incident or Complaint
Your Name
Your Phone Number and/or Email Address
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