Complaint Forms

Click on a link below for a complaint form regarding:

A Food Service Establishment in the Town of Derry;

A Residential property in the Town of Derry, for reasons such as:

        Lack of adequate heat or hot water in a rental unit;

        Insect or vermin infestation in a rental unit;

        Trash, junk or other public health nuisance at a residential property.

These forms should be submitted to the Bureau of Public Health via fax, email or mail.  Upon receipt of the completed form, a representative from our office will contact you to discuss your complaint.