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Foodborne Illness Complaint Form Incident/Outbreak ID#: Complainant ID #: Origin of Complaint Date Received: Receiving Agency: Call Received By: Complainant Data Name: DOB: Gender: M F Race: W B H
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What is preliminary foodborne complaint form?
The preliminary foodborne complaint form is a document used to report suspected cases of foodborne illnesses.
Who is required to file preliminary foodborne complaint form?
Food service establishments, food manufacturers, and individuals who suspect foodborne illnesses are required to file the preliminary foodborne complaint form.
How to fill out preliminary foodborne complaint form?
The form can typically be filled out online or submitted in person, depending on the jurisdiction. It requires details about the suspected illness, the food consumed, and contact information.
What is the purpose of preliminary foodborne complaint form?
The purpose of the preliminary foodborne complaint form is to track and investigate potential cases of foodborne illnesses to prevent outbreaks and protect public health.
What information must be reported on preliminary foodborne complaint form?
Information such as symptoms experienced, food consumed, date and location of consumption, and contact information of the complainant must be reported on the preliminary foodborne complaint form.
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