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Environmental Health Complaint Form

  1. Jefferson County Health Department

    715 Green Road
    Madison, IN 47250
    Phone: 812-273-1942
    Fax: 812-273-1955

  2. Complaints registered with the Jefferson County Health Department must be in writing and signed by the person filing the complaint.

    All complaints must be of Public Health or Environmental concern.

  3. I hereby register a complaint with the Jefferson County Health Department regarding the following:

  4. If you would like a return phone call from the Jefferson County Health Department Staff you must provide phone number

  5. Leave This Blank:

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