2. This form is only for submitting comments/complaints to the Lucas County Coroners' Office Toxicology Department. We cannot forward comments to other departments.

4. First Name*
5. Last Name*
7. Company / Organization
9. Address1*
11. Address2
13. City*
14. State*
15. Zip*
17. Contact

    1. Yes
    2. No

    Would you like to speak to somebody about this matter directly?

18. Email*
19. Phone Number*
21. Comment / Complaint
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

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