Skip to main content
Menu
Toggle navigation
Public Health Madison & Dane County
Environmental Health
Health Services
Community Initiatives
Data & Publications
Media
Español
About
Search form
Search
Search
COVID-19 Vaccine:
posted Friday, Mar. 13, 2020 – 4:54 pm
Learn more about who is eligible for vaccine.
Public Health
Report
Report an Environmental Health Problem
Report an Environmental Health Problem
You must have JavaScript enabled to use this form. Please enable JavaScript and reload the page. If you cannot enable JavaScript, please contact
webadmin@cityofmadison.com
to provide your information.
Type of Report
*
Public Swimming Pool / Whirlpool
Restaurant or Retail Food Establishment
Septic System Issue
Lodging Conditions
Mold
Air Quality Problem
Pests
Unsanitary Living Conditions
Tattoo or Body Piercing Establishment
Date of Incident
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2019
2020
2021
Address of Incident
*
Please describe the incident, including date, time and location.
*
Photo Upload
Accepted file types: jpg, gif and png. Maximum file size: 10 MB.
Upload
Have you reported this incident before?
*
No
Yes
Contact Information
First Name
*
Last Name
*
Would you like us to contact you about this report?
No, do not contact me.
Yes, by phone.
Yes, by email.
Email Address
Phone
Report an Environmental Health Problem
Leave this field blank
Submit
