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Online Complaint Form: Tattoo or Piercing Facility

Instructions: Please enter as much information as possible. Items with * are required fields. Any information you provide is confidential.  You may choose to remain anonymous however please enter a valid e-mail address and telephone number in case we need to contact you for additional information. When you are finished click the "Submit" button. If you prefer, you may file a complaint by phone at (716) 961-6800. Thank you. 

Tattoo/Piercing Facility Address
Your Name
Your Telephone Number