Environmental health service request

Submit the form below to lodge an environmental health service request. Please note that food and noise complaints are separate to the below form.

First name*

Last name*

Address*

Suburb*

Postcode*

Daytime contact number*

Email*

Address of alleged offending property*

Prior to investigating a request, the City expects that an individual has made a reasonable effort to resolve the issue(s) themselves, unless there is a justifiable reason why this cannot occur.

Have you attempted to resolve this matter?

YesNo

Type of request*

Please provide further details about the issue*

What impact does the matter have on you?*

What outcome would you like to see from this service request?*

Please attach photographs or other relevant documentation to support your service request

Declaration*
By checking this box, you are acknowledging the following; the City of Stirling is subject to the Freedom of Information Act 1992; Complaints may be dealt with in order of priority, as determined by the City; Should legal action be initiated by the city, you may be required as a witness to give evidence in Court.

Retype the numbers below:


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Environmental health service request

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