Forms Report a food safety issue online

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Contact details

Name

Address

Contact number

Email address

Premise information

Name of the supplier where you purchased the food

Address

Purchase date

Have you been ill?

Yes No

Have you visited your GP?

Yes No

Type of food problem

Dirty conditions of food premises Foreign bodies in food, e.g. glass,metal, plastic Poor handling of food by shop assistants Suspected food poisoning following eating from a restaurant or other food premises. Unpleasant taste of food

Further information

Please provide any further information

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