Free Foodborne Illness Complaint Form

Encourage self-reporting with a foodborne illness complaint form that can easily be accessed anytime and anywhere, making it easier to efficiently gather information on possible food safety threats straight from the affected individuals.

food technician referring to a foodborne illness complaint form to investigate their products

What is a Foodborne Illness Complaint Form?

A foodborne illness complaint form is a standardized document used by employers, health departments, and environmental health specialists to collect information from individuals such as customers and employees who report experiencing foodborne illness symptoms. This tool is crucial for investigating potential food safety threats and possible foodborne illness outbreaks. and understanding the circumstances surrounding reported illnesses.

Importance

Using a foodborne illness complaint form is essential in recording and addressing foodborne illness outbreaks. It primarily helps contribute to faster and more effective food illness or poisoning investigations, as it helps streamline the implementation of complaint systems and the overall incident reporting process. This also encourages more prompt and efficient follow-ups from all parties involved.

Foodborne illness complaint forms also help in addressing food safety concerns faster. In the US specifically, using a templated complaint form has helped health officials and safety workers determine the causes of different food safety-related outbreaks quicker, as it organizes all important information into easily digestible sections for analysis.

The introduction of web-based complaint forms have further improved this, helping officials address foodborne illnesses better and in a more timely manner. This prompted the investigation process to start right as the complaint was received, ensuring quicker turnaround times and results. The data collected from foodborne illness complaint forms can also be used by public health officials, employers, and safety managers in creating and improving food safety, storage, and handling policies and regulations to mitigate future risks.

What to Include in a Foodborne Illness Complaint Form

To ensure your foodborne illness complaint form can accurately and efficiently capture the necessary information for the investigation, it must have fields for the following:

  • Date form is filled out
  • Personal details of affected individual, such as the following:
    • Name
    • Address
    • Age
    • Sex
    • Contact number
    • Email
  • Classification of the affected individual, if they are an employee of the organization or a customer
  • Date the affected individual consumed their meal
  • Onset of foodborne illness symptoms
  • Symptoms experienced
  • Current health status of affected individual
  • Checklist for additional details such as the following:
    • Has the affected individual been out of town or country in the last few days?
    • Has the affected individual consulted a doctor for their symptoms?
    • Has the affected individual’s symptoms persisted for more than 24 or 48 hours?
    • Has the affected individual consumed other food in the last 24, 48, and 72 hours?
    • Has the complaint been shared or escalated to other establishments or legal bodies?
    • Is anyone in the affected individual’s immediate household also experiencing symptoms?
    • Have the suspected food items been tested?
  • Additional comments and suggestions
  • Further actions to take
  • Name and signature of affected individual

Here is a sample foodborne illness complaint form in use for reference:

How to Use

A foodborne illness complaint form is typically used in two ways: to collect complaints from customers, or to gather reports from within an organization about a possible foodborne illness outbreak. In both cases, the form is used to gather information first systematically, thus becoming the basis of the investigation to be conducted.

For investigating customer-related foodborne illness complaints, after all necessary data has been gathered, the establishment should then share the form to the right doctors and public health officials or offices. The customer should also have a copy of the form submitted as well as the report filed by the establishment for transparency. These documents will then be used to keep the customer informed on all proceedings moving forward.

The same process will be followed with any internal cases of suspected foodborne illness outbreaks. However, food poisoning and other cases will be treated as a workplace injury as per the US Occupational Safety and Health Administration (OSHA). These cases should then be recorded as such, especially if the food ingested by employees were made in the workplace or provided for by employers, or was contaminated with workplace hazards such as dust, lead, and other chemicals.

Foodborne illness complaint forms should also be kept in a cloud storage, making it easier for it to be accessed anytime and anywhere for reference. Following this, it would be best to digitize your complaint forms and other documents essential to the case, giving you, customers, and employees flexibility and ease of access in reporting issues and concerns. This also promotes a more open communication system, as it ensures all involved parties are always aware of how the investigation is proceeding.

FAQs about Foodborne Illness Complaint Forms

Ideally, all suspected cases of foodborne illness or food poisoning should be reported. This is because they need to be investigated for possible harmful bacteria that cause serious complications, such as Salmonella, E. coli, norovirus, hepatitis, and botulism.

Safety managers, employers, and dedicated food safety managers are often responsible for managing the use and implementation of foodborne illness complaint forms, as they are the basis for food poisoning investigations. In some cases, an organization’s Information Technology (IT) team may also be involved, especially in the case of digital web-based forms.

Food poisoning or foodborne illness complaint investigations are often prioritized based on the number of people affected and severity of symptoms. High priority cases involving multiple people or confirmed diagnoses may be investigated the same day. Lower priority single-person complaints are typically investigated within 24 hours.

Roselin Manawis
Article by

Roselin Manawis

SafetyCulture Content Specialist
Roselin Manawis is a content writer and researcher for SafetyCulture. She has experience in news writing and content marketing across different fields of discipline. Her background in Communication Arts enables her to leverage multimedia and improve the quality of her work. She also contributed as a research assistant for an international study and as a co-author for two books in 2020. With her informative articles, she aims to ignite digital transformation in workplaces around the world.

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