WHO:
Your name, address and telephone number. Please
provide the names and telephone numbers of other people
if others also became ill. This information is kept
confidential, but it is important for our field
inspectors to have the ability to contact you for
additional information related to the investigation.
WHERE:
The food facility's address and telephone
number. Please include the name of the business.
SUSPECTED FOOD:
Describe all of the foods eaten during the meal
suspected of causing the illness. Additionally, it is
important to note the date and time the food was eaten
as well as the date and time of the first symptoms.
SYMPTOMS:
List all symptoms experienced during the
illness. This information will help the Specialist in
investigating the food facility.
FOOD HISTORY:
Be prepared to answer questions regarding all
of the foods eaten and beverages consumed in the three
days prior to the first sign of illness. Many foodborne
illness organisms can have incubation periods of three
days or longer. The food history is necessary to help
the Specialist identify the most likely suspected food
item.