This Complaint Intake Form is for COVID-19 (Coronavirus) related complaints that occur in Ross County, OH.  The Ross County Health District will investigate complaints based upon the information reported by the complainant and the current public health orders in place by the Ohio Department of Health or Ohio Governor at the time of the complaint. 

 Providing detailed information will help our agency investigate the complaint.  

Please remember, your complaint is public record and subject to review through public records request by others.

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* 1. What date and time did the complaint or issue occur?

Date
Time
Information about the Complaint

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* 2. What is the Business or Employer Name?

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* 3. What is the business or employer address?

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* 4. What is the business or employers contact information

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* 5. What is the type of business, employer, or workplace?

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* 6. What is the nature of the complaint (check all that apply)

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* 7. Please provide any additional comments related to the complaint

Complainant Information (Your Information)
RCHD does not require you to report your name or contact information but it can help our staff investigate the complaint and contact you if more information or questions are needed.

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* 8. Please provide your contact information if you would like to be contacted to discuss the complaint.

Thank you for submitting your concerns.

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