Complete this form to submit a complaint regarding a potential violation of the Smoke-free Illinois Act. Information marked with an asterisk (*) must be completed in order for the complaint to be investigated.
Information entered in this complaint form will only be provided to authorized enforcement agencies, as described in the Smoke-Free Illinois Act. Complaints are considered a "tip" to alert officials of where enforcement and follow-up efforts should be focused. Therefore, any citations written for violations of the act will be based on the eye-witness account of the enforcement official observing the violation of the law. Providing your name and/or phone number is NOT a requirement to file a complaint. If you voluntarily provide your name and contact information, the enforcement agency may contact you with follow-up information. In these instances, your contact information will be kept confidential by these authorized enforcement agencies. If you would prefer to speak with someone directly regarding the violation, you may also contact your local health department in order to issue a complaint.
Note: The Smoke-free Illinois Act provides that no individual may be discriminated against in any manner for exercising their rights under this law.
* CHECK THE FOLLOWING BOX TO SHOW THAT YOU UNDERSTAND THE INFORMATION IN THIS COMPLAINT WILL BE RELEASED TO AUTHORIZED ENFORCEMENT AGENCIES.
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