Accessible Customer Service Feedback Form

Please use the below text area to provide additional details.
Please contact me
If you wish to be contacted by a staff person, please provide your information*:
Please enter your complete address

*The Personal Information in this Accessible Customer Service Feedback Form is collected in accordance with the Health Protection and Promotion Act and privacy laws.  The information will be used to deliver public health programs and services, ESTPH’s customer service commitment, AODA requirements, and may also be used for evaluation or statistical/research purposes. Questions about the collection of this information should be directed to: 

ESTPH Privacy Officer
Elgin St. Thomas Public Health
1230 Talbot Street, St. Thomas, ON N5P 1G9
519-631-9900; Fax: 519-631-3745; Email: estph@elginhealth.on.ca