Public Health Complaint Form

Public Health Complaint Form

All fields are mandatory unless marked as (optional). Please note that this form is for reporting problems within City of Cockburn only.  All barking dog complaints should be directed to our Rangers Services Department.

Contact name and details

Address of premises causing nuisance

Issue details

Please note:

1. Your details will be kept confidential, however the City of Cockburn is subject to the Freedom of Information Act, 1992.
2. While every effort will be made to resolve your request promptly, please understand that Council has limited resources and environmental health issues need to be dealt with in order of priority.
3. Council undertakes to notify you within 5 working days of this form being returned of how your request has progressed.
4. Should further detail be required, an officer will contact you via phone or e-mail.
5. Should this matter be referred to Court for prosecution, you will be called as a witness.