Smoking Ordinance Complaint Form

	Smoking Ordinance Complaint Form
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Links

2008 smoking ordinance information

Smoking ordinance text

City Clerk's Web page on the current ordinance and its history (also includes text and PDF format of the ordinance and explanation fact sheets)

Smoking Ordinance Complaints
Thank you for your concern about Environmental Tobacco Smoke. Exposure to ETS, also known as passive smoking or secondhand smoke, is a known cause of disease and illness. On April 8, 2008, Kansas City voters approved a smoking ordinance that included all bars and restaurants, which takes effect 12:01 a.m. June 21, 2008.

Please fill out this form to report violations of Kansas City's Smoke Free Air Ordinance. The Health Department will follow up on the complaint with the information you provide. Enter all the information requested. Providing your name and contact information will enable us to contact you if we need additional information to respond to your complaint. After you've entered the required information, use the Submit button at the bottom of the form to send it.

Asterisks (*) denote required fields

Date of complaint (Today's date e.g. mm-dd-yy):*
Name of business:*
Type of establishment*
Store Office Bingo hall Billiard hall Bowling alley Theater or auditorium School Hospital Health clinic Gymnasium Apartment building Sports arena or concert hall Bar Restaurant Casino Other
Address (number and street):*
ZIP code:
Business phone number:
Date of occurrence:*
Time of occurrence:
Description of violation (check all that apply):*
Customer smoking Employee or owner smoking No-smoking sign not posted Smoking allowed in no-smoking area Smoking policy not available or disseminated Person-in-charge fails to inform violator(s) to stop smoking Other (describe below)
Briefly describe the violation below (if other than above):

Location within establishment where violation was observed:
Your name:
Your phone number:
E-mail:
Complainant's street address:
City:
State:
ZIP Code:
Thank you. The Health Department will respond to complaints about violations of the Smoke Free Workplace Ordinance (Article XII, Sec 34.471-34.480). The department will take whatever action may be necessary as indicated by the circumstances, including inspections, as necessary, to determine if violations have occurred. Please be aware that the City Ordinance does not regulate smoking in private residences, certain hotel rooms and other locations specified in the ordinance.

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