Consumer Affairs Questions/Feedback

If you are a resident of Palm Beach County and wish to submit a new dispute against a business, please click here, otherwise use this Feedback Form.

Your Contact Information

*Required field
*First Name:		*Last Name:
*Address:
*City:	State: Zip:
Home Phone:		Work Phone: Ext:
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone (561-712-6600) or in writing.
Email:	Fax:

Business Information

Are you(Select one)
	A consumer
	Representing a business/organization
Name of business/organization:
Is this information related to an active case with Palm Beach County Consumer Affairs?
	No
	Yes If Yes, provide Consumer Affairs Case Number:

Feedback

Explain your feedback or request for assistance(Please be brief, but specific).
Subject:

Please carefully review the information you have entered before hitting the submit button. Please do not submit the same message more than once, doing so may delay processing.

Notification Disclaimer:

Information provided to the Consumer Affairs Divsion is considered a public record. Please do not include Social Security Numbers or bank/credit card account numbers. Communications made through this electronic message system shall in no way be deemed to constitute legal notice to the Palm Beach County Consumer Affairs Division, employees or representatives with respect to any existing or potential claim or cause of action.