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Ombudsman Complaint Form

This form is used to file any complaint you may have against the Louisiana Department of Environmental Quality or one of its employees. For immediate assistance, please call the LDEQ Ombudsman at 225-219-3258. Complaints about violation of environmental laws and regulations or facilities' activities should be made to the LDEQ SPOC at 225-219-3640 or on-line at http://www.deq.louisiana.gov/apps/forms/irf/forms/.

Note: If you wish to remain anonymous, please leave personal information blank.

First Name	Last Name

Street	City

State	Zip

Phone #	Fax #

Email Address

Against which individual, program, practice or process do you wish to complain?

When did it come to your attention?

What is the decision or matter about which you complain?

What result do you hope to achieve with your complaint?

Have you already contacted the Department in order to resolve the problem?
YesNo
Who was contacted? When? What happened?



Do you agree that your complaint may be passed on to another authority if the Ombudsman decides that he is not the appropriate person to deal with it?
YesNo

Submit