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Report Food-Related Illness

  1. Report a Food-Related Illness

    If you believe you or someone you know got sick from food, even if you don't know what food it was, please complete this form or call 303-271-5700. Reporting an illness helps us identify sources of foodborne outbreaks and prevent others from getting sick.

  2. What to Expect

    Once you've reported the illness, we will follow-up with some questions. Please be prepared to share more details. Remember, we are trying to narrow down the cause of your illness.

  3. Common Symptoms

    It may take anywhere from less than an hour to over several weeks for symptoms to appear. While most people have only mild illnesses, lasting a few hours to a couple of days, some require hospitalization and can suffer long-lasting effects. The most common symptoms include: upset stomach, stomach cramps, nausea, vomiting, diarrhea and fever.

  4. (in days and/or hours)

  5. Doctor or hospital visit?

  6. When to Seek Medical Attention

    If you experience symptoms of food poisoning, such as diarrhea or vomiting, drink plenty of fluids to prevent dehydration. See your doctor or healthcare provider if you have symptoms that are severe, including:

  7. (include times / locations for breakfast, lunch, dinner and all snacks)

  8. (include times / locations for breakfast, lunch, dinner and all snacks)

  9. (include times / locations for breakfast, lunch, dinner and all snacks)

  10. Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at www.jeffco.us/privacy. By submitting this form, you acknowledge and accept the terms listed in the privacy policy.

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