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Report a Foodborne Illness

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Use the form below to report a foodborne illness or food safety concern.

If you would rather report by phone call (253) 798-4712.

All reports are investigated promptly. We ask you to submit your contact information so we can contact you if we have questions or need clarification during the investigation.

An * means that the field is required.

Please correct the field(s) marked in red below:

Your Contact Information

Keep my name and contact information confidential.
Confidential
 *
Confidential
Name
 *
Email Address
Telephone Number
 *
I would like to be contacted with the results of the investigation by:
Contact Options
 *
Contact Options

Name of Food Establishment and Location of Incident

Name of Food Establishment
 *

Location of Incident

Enter the address (street address, city, and zip code) of the food establishment. If you are unsure of the exact name, or address use our online Food Inspection Database to look it up.

 

If the incident is associated with a temporary event or a mobile food establishment give as much detailed information about the name and location of the establishment as you can.

Location

 *

Reporting the Problem

Date and Time of Meal
 *
Description of Incident
 *
  1. To receive a copy of your submission, please fill out your email address below and submit.