Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Report a Public Health Problem

  1. Report a Public Health Problem

    This is the form you need to use to report a public health problem such as health violations related to a licensed childcare, pool/spa, or tattooing facility, sewage or chemical spills, waste issues, indoor/outdoor air quality problems, water problems, or animals bites. The location of the problem must be within Jefferson County. NOTE: If you are looking to report a violation of the Colorado Stay-at-Home order, complete this online form:


    Jefferson County Public Health does not have enforcement authority for all public-health related complaints, such as housing, mold, bed bugs, trash and work safety. If you have a question about a topic not listed below, please call our main office at 303-232-6301.

  3. Please indicate the area of your problem by checking the appropriate box(es):

  4. Leave This Blank:

  5. This field is not part of the form submission.