Report suspected food poisoning
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Report suspected food poisoning

Fill in this form if you think you, or a member of your family, have suspected food poisoning

  • It will take you about 15 minutes to complete the questionnaire.
  • It is advisable to have your calendar or diary with you when completing the questionnaire as this may help you remember important dates relating to your illness.
  • It is very important for our investigation that a faeces sample is also submitted. You will be sent a faeces bottle which you should use for your sample.
    • Your enquiry will receive a limited response if you are not willing to submit a faeces sample.
    • You will be contacted by Environmental Health should they need further information.

About the person who is ill

Date of birth *
Date of birth
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