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Arkansas Department of Health
Arkansas Clean Indoor Act - Complaint Form
You may file a complaint electronically or by mail. To file an electronic complaint please complete the following information and press submit. To file a complaint by mail, please download and print the PDF version of the complaint form and mail the completed form to: Arkansas Department of Health, Environmental Health Branch, 4815 W. Markham, Slot 46, Little Rock, AR 72205-3867.

Date:

 
Complaint Reported by:
or Anonymous
 
Complaint Information
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AR
Code:
:
(XXXXXXXXXX)
*Type of business:
 
 
*Description of violation (check all that apply):
 
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* denotes required field



   

NOTE: This information is available under Freedom of Information Act. Complaints are accepted anonymously.

Complaints are public information. By submitting a complaint, you may be required to testify to the violations witnessed. Please return the completed form to: Arkansas Department of Health, Environmental Health Branch, 4815 W. Markham, Slot 46, Little Rock, AR 72205-3867 or call 1-800-235-0002.
       
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