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REPORT A FOOD SAFETY CONCERN

IMPORTANT:

  • If you feel like you became sick from eating food from a Food Service Establishment in Kitsap County please do not provide any symptoms on this form. The Health District will respond to your submittal and may contact you the following business day for more detailed information.

YOUR CONFIDENTIALITY


We may use your contact information to follow up with you. If the information you provide is incorrect or incomplete, we may not be able to respond.

YOU MUST SELECT ONE OF THE FOLLOWING THREE OPTIONS TO FILE A REPORT:

I am providing my contact information and you may share it if requested.
I am providing my contact information and want my identity to be confidential.
I choose not to provide my contact information.

Your Name:
E-mail:
Phone:
Food Establishment Name:
Is this regarding a Foodborne Illness?



Concern: (If this is an Illness submittal you may outline the food(s) consumed, but please do not submit any symptoms at this time).
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Thank you. We value your time.

 


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