Required fields are marked with asterisks (*)

Submit a complaint about stagnant water on public property

Durham Region Health Department only conducts investigations of stagnant water on public property.

To report stagnant water on private property, please contact your local municipal by-law office.

By completing this form, you acknowledge and understand:

You are agreeing to be contacted by email.
Sharing of personal and/or personal health information via email should be kept to a minimum.
Any personal and/or personal health information that you provide to us via email will only be used to respond to your message and/or provide you with the requested information.
While steps are taken to protect the privacy and security of emails, sending and receiving emails over the internet is not secure. We cannot guarantee the security of any messages sent or received.
Your information may be used internally for planning, evaluation and program improvement purposes.
You may withdraw your consent to the use of email at any time by contacting us.
Do not use email for emergency or urgent health care matters.
That the information provided is accurate and correct.

Complainant information

First name:

Last name:

Phone number:

Email address:

Property/site information

Property address:

Postal code:

Have you contacted the municipality of the stagnant water site to report your concern?

Yes

You can upload a maximum of four (4) photos. Our system is unable to process/accept files larger than 3MB. If the photos you are attempting to send us are greater than 3MB, you will need to reduce the file size prior to uploading them through our online form.

Please descibe the location of stagnant water site

If possible, please upload photos of the site/location

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Collection of personal information
The personal information provided in this form is collected under the authority of the Health Protection and Promotion Act R.S.O. 1990 c.H.7, s.5 (as amended). This information is collected and used for the purpose of preventing, eliminating and/or decreasing the effects of a health hazard. Questions about this collection and use of information should be addressed to the Manager, Health Information, Privacy and Security at 605 Rossland Road E., P.O. Box 730, Whitby, ON, L1N 0B2, (905) 668-7711.