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California Department of Education Nutrition Services Division, Food Distribution Program Form Number: FDPF103 (7/2019)U.S. Department of Agriculture Foods Complaint Instructions General Information The
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How to fill out complaint form - food

01
Obtain a complaint form from the responsible authority or organization dealing with food complaints.
02
Read the instructions and guidelines provided on the form carefully before filling it out.
03
Provide your personal information accurately, including your full name, contact details, and address.
04
Clearly state the nature of your complaint regarding food, be specific about the incident, and provide relevant details such as date, time, and location.
05
Attach any supporting evidence or documents that can validate your complaint, such as receipts, photographs, or witness statements.
06
If you faced any health issues due to the food, mention the symptoms, severity, and any medical assistance sought.
07
Sign and date the complaint form to affirm the accuracy of the information provided.
08
Submit the completed form to the designated authority or organization through the specified channel, such as in-person, mail, or online submission.
09
Keep a copy of the filled complaint form for your reference and records.
10
Follow up with the authority or organization to inquire about the progress and resolution of your complaint.

Who needs complaint form - food?

01
Anyone who has experienced a negative incident or issue related to food can utilize the complaint form.
02
Consumers who have received contaminated, spoiled, incorrectly labeled, or unsafe food products.
03
Individuals who have encountered unhygienic conditions at a food establishment or witnessed improper handling of food.
04
Customers who have been subjected to misleading advertisements, false claims, or misrepresentation by food businesses.
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People who have suffered from foodborne illnesses or allergic reactions due to the consumption of certain foods.
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Residents who have noticed unsatisfactory food service in public facilities like hospitals, schools, or government institutions.
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Customers who have encountered poor customer service or unsatisfactory experiences at restaurants, cafes, or food stores.
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Individuals who wish to report violations of food safety regulations or questionable practices in the food industry.
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Consumers who want to ensure their rights are protected and seek appropriate compensation or action for their food-related complaints.
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