Environmental Laboratory Accreditation Program Complaint Form

Use this form to notify the Minnesota Department of Health (MDH) Environmental Laboratory Accreditation Program about laboratory activities or the quality of data produced by a certified laboratory that may required MDH attention.

The required fields in Section 1 and either a box must be checked or a description of an issue must be completed in Section 2 to submit this form. No investigation will occur without these sections being completed. In Section 3, we are requesting your name and phone number so that we may contact you if further information is necessary. You have the option of indicating if you want to be contacted to let you know how your complaint was handled. You are not required to supply identifying information. If you do provide identifying information, it will be treated as confidential information and can only be released to MDH employees who need it to process your complaint, department representatives in the Attorney General's Office, the courts, and anyone having a court order to obtain the information.

This form is designed to improve public access to the MDH. Submitting it to us is voluntary.

Section 1

required
required
required

Section 2

Please check all that apply to your complaint. required
Programs(s):




Observations and Concerns:





: [ 1000 character limit ]

[ 1000 character limit ]

Section 3

Information on Complainant
 
To prevent abuse of this form, please type the following letters/numbers VDSGE into the field below. Thank you.
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