Los Angeles Fire Department Smoking Complaint Form
Complete this form to submit a complaint regard i ng a potential violation for smoking in a smoke-free area In the City of Los Angeles, smoking includes the use of an electronic smoking device (such as an e - cigarette). You may submit your complaint anonymously. If you wish to remain anonymous, please skip to Sect io n 2.
SECTION 7: First Name
Your Phone Number (include area code)
Your Email Address
SECTION 2: Complaint Descr iption
Type of Violation *
0 Smoking a Toba cco Product (Cigarette, P ipe, Hookah pipe etc.) in a smokefree area
0 Using an Electronic Smoking Device (E-Cigarette, Vape pen, etc.) in a smokefree area
Who was smoking or using an electronic smoking device in a smokefree area*
D Owner/Manager/Person(s) i n charge
D Employee/Worker(s)
0 Customer/Patron/Vis itor(s)
D Other Location Information: