MNELAP Complaint Form

Minnesota Department of Health (MDH) Environmental Laboratory Accreditation Program

Use this form to notify the Minnesota Department of Health (MDH) Environmental Laboratory Accreditation Program about laboratory activities or the quality of data produced by a certified laboratory that may require MDH attention.

In Section 1, the fields, Laboratory name, City and State, are required to submit this form.

In Section 2, a box(s) must be checked or a description of an issue completed (other; please specify) also for submittal. No investigation will occur without these sections being completed.

In Section 3, we are requesting complainant information so we may contact you if further information is necessary.

Note: You are not required to supply your identifying information. If you do provide your identifying information, it will be treated as confidential information and can only be released to MDH employees (who need it to process your complaint), department representatives in the Attorney General's Office, the courts, and anyone having a court order to obtain the information.

Submitting this form to us is voluntary.

Section 1

Section 2

Please check all that apply to your complaint.

Program(s) and Observations/concerns
Please describe in detail the nature of the complaint/concern. Please describe any supporting documentation you have which may assist us in our investigation.

Section 3

Complainant information