Food Poisoning

This form can be used to report a case(s) of suspected food poisoning.

Do you work with vulnerable people e.g. the elderly, children? *

You should not go back to work until 2 days after the symptoms have gone.

Where did you eat the suspect item? *

Symptoms: *

How many people affected: *

Please enter number of people affected:

How long have you had symptoms: *

We will not investigate this but will keep a record of the incident.

Have you seen your doctor and provided a sample : *

Please can you provide the results when received. Without a confirmed result of food poisoning we will not investigate but will keep a record of the incident.

Unless we have confirmed results of food poisoning which can only be found out by having a sample analysed through the doctor we will not investigate this issue but will keep a record of the incident.

Premises details

Business name: *

Premises Address: *

Your contact details

Title: *

First name: *

Surname: *

House name/number:

Postcode: *

Phone number:

If we need to phone you our number will show as withheld.

Email address:

Please note that we may use your email address for future correspondence.

Please enter a valid email address or leave blank if you do not have an email address

Additional information:

The Community Safety team do not routinely launch an investigation into every report which is made to them. Each case is assessed and prioritised based on a range of risk factors, so that resources are directly at the highest areas of risk. However, we do monitor all information given to us and use it to inform the wider concerns which may exist.

Data Protection

The information you have provided on this form will be used to deal with your request by the relevant department. We may pass your details on to contracted third party service providers. We will store a copy of your completed request as a backup for 12 months.

If you would like to know more about how we use your information and how you can exercise your information rights please see our privacy notice.

Please tick to confirm you accept these conditions.