* These field/s must be completed
Information about the council's processes for managing suspected cases of food poisioning
Please provide as many details as possible
When did you eat the food? *
When did you become sick? *
What are your general symptoms *
Did you require medical attention?
Has anybody else become sick?
Are they able to contact the council?
Name or location of the business/shop/restaurant
Have you contacted the business/shop/restaurant?
What was the outcome of this contact?
Do you have a sample of the food? (if relevant)
Additional information *
In most cases food poisoning is caused by food consumed in the last 24 hours. In some cases it may be caused by food consumed over the last 3 days and on rare occasions it may be caused by food eaten in the last 7 days
What food have you consumed in the past 24 hours?
Images must be .jpg, .pdf, .doc or .xls format and less than 2MB in size
Attachment 1
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Attachment 2
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Attachment 3
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