Smoking Complaint Form

Please fill out this form to report complaints involving smoking issues. Environmental Health Services and Facilities Management will follow up on the complaint with the information you provide.

Please enter all of the information requested. By including your name and contact information it will enable us to contact you if we need additional information to respond to your complaint.

*CSU's Building:
Other location details:
*Date of occurrence:

 
*Approximate time of occurrence:
*Description of Incident
(check all that apply):







Additional Info.
Reporting Party Information: (**Note names or reporting parties will not be disclosed)
*First Name:
*Last Name:
*Phone:
*e-Mail:
CSU Building:
Address:
City:
State:
Zip Code:

Please note, while your complaint is important to us, we may not be able respond immediately to the complaint, but will investigate it to determine if there are areas where better signage or other facilities modifications may be recommended to address recurring issues in a particular area of concern.