Fort Wayne Allen County Department of Health Uncategorized Tháng Năm 30, 2023 by qtvadminContentsAllen County Health Dept Complaint FormAllen County Health Dept Complaint FormThis complaint form is to be used for registering a complaint regarding a food establishment or hotel within Allen County. The department will respond to complaints as soon as possible. Complaint Type: Choose one…Food Establishment ComplaintHotel / Motel ComplaintEstablishment Name: Establishment Address: Date Complaint Observed: If Submitting A Hotel / Motel Complaint: Location of Complaint: (ie. Room Number) Complaint Observed:Did You Contact Management?YesNo If So, List the Name of Contact: If Submitting A Food Complaint: Nature of Complaint For multiple choices, use the CTRL key Unsanitary EstablishmentImproper Food HandlingFood Handler HygieneFood Contamination / Adulteration / SpoilageIllness** If complaint is of illness, be sure to submit name and daytime phone number. A department representative will contact you for more information. Please do not submit any medical information. List the Complaint:Was the food consumed in the establishment or carried out?In the establishmentCarried Out What food was involved?:Your Contact Information (optional)If complaint is of illness, be sure to submit your name and daytime phone number so that a department representative can contact you for more information. Name: Daytime Phone Number: Address: Submit Complaint
