COVID-19 Public Health Concern Form
At this time Pitkin County Public Health has created a monitoring and compliance system in partnership with local jurisdictions to ensure the necessary face covering and COVID-19 safety protocols are followed.
This form is for violations of the public health order that are not an immediate risk to your personal safety but of a community health concern related to COVID-19. Please contact the non-emergency dispatch number 970-920-5310 for COVID-19 personal safety concerns.
A County Consumer Health Protection Specialist or local government official will respond to your request within 2 to 3 business days.
Name of Submitter
Please provide as much detail of your complaint by answering the following questions. A Consumer Health Protection Specialist or local government agency may follow up with you either by phone or email for additional information.
Date of Observation
Time of Day of Observation
Location of Complaint (street number & street name)
Location of Complaint: City, Town or Unincorporated Pitkin County
Unincorporated Pitkin County (such as AABC/North Forty)
Type of Business
Education / Child Care
Place of Worship
If a Business, Name and Contact (if available)
Type of Complaint
Cleaning & Disinfecting
Improper Mask Use
Description of complaint
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This form was created inside of Pitkin County.