Customer Food Complaint/Food Poisoning Form

How to use:
Despite the best intentions, sometimes customers have cause to
complain about the food they have been served or sold.
If a customer has a food complaint, they must be dealt with in an
efficient, sympathetic and courteous manner.
Use this form to record details of the complaint.

This template is part of the barbox.com Business Resources package, supplied by the providers of all
our Health & Safety content and comment, Perry Scott Nash.

CUSTOMER FOOD COMPLAINT/FOOD POISONING FORM

Outlet Name:

Date Complaint received:

Location:
COMPLAINANT DETAILS
Name:
Address:
Telephone Number:
PERSON DISCOVERING UNSATISFACTORY FOOD/FOREIGN BODY (IF DIFFERENT FROM
ABOVE)
Name:
Address:
Telephone Number:
ABOUT THE COMPLAINANT
Nature of complaint:
Food complained of:
Date/Time/Location of purchase:
Date/Time/Location where food was consumed:
Description of Circumstances surrounding discovery:
SUPPLIER OF FOOD
Date coding:
Batch no./coding:
Delivery date:
Is a letter required to be sent to the customer?
YES/NO
COMPLETE IF FOREIGN BODY FOUND
Has customer surrendered food/object?

YES/NO

Object colour:

Object size:

Object weight:

Possible identity:

Where EXACTLY found in food?

OTHER INFORMATION

Person initially receiving the complaint:

Pub Manager:

Name:

Name:

Signed:

Signed:

NB: IF COMPLAINANT ALLEGES ILLNESS COMPLETE SUSPECTED FOOD POISONING

INVESTIGATION FORM