Cosmetology Complaint FormServices Disease prevention Disease testing Disease treatment Report a foodborne illness Request an immunization record Information for: General public Healthcare providers Media Schools and childcare One Health in Utah Health departments Public health departments Cosmetology facility complaint form—Contact us Your name Your number Your email If you don't provide name, number or email, then you will not be able to ask about the status of the investigation or receive any results of the investigation. Facility Information Facility Name* Address (Street/City/ZIP code)* Complaint Information Have you reported your concerns to the local health department? YesNo Have you spoken with anyone at the facility regarding your concerns? YesNo If yes, with whom did you speak and has there been any change? Incident Details Provide as much information about your concerns including date(s), time, names of individuals involved and their titles, names of witnesses and their contact information, where the incident(s) occurred, etc. protected by reCAPTCHA Privacy │ Terms