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Smoke-Free Law Complaint Form

Please fill out this form to report concerns related to the North Dakota Smoke-Free Law. Fargo Cass Public Health will investigate the concern with the information you provide. Please enter as much information as possible. Giving your name and contact information will enable us to contact you if we need additional information to respond to your concern, but you may remain anonymous if you like.

If you have any questions or would like further information, please call Fargo Cass Public Health at 701.241.1360.


Location


Date and Time of Violation

Check all that apply and briefly describe the violation below.


Violation reporter (optional)

Additional Comments




Fields marked with * are required.