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Environmental Health

Restaurant Illness Complaints

Please provide as much information as possible. All information will be kept private and confidential. You may be contacted by the Kalamazoo County Health Department to collect more information if needed.

* Fields are required. All information is confidential and will remain anonymous. Some form of contact information must be provided so that health inspectors can follow up with any additional questions.

Symptoms (Check all that apply) *   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Doctor Visit for Illness   
Same household (Same address)   

Please provide us with a 72-Hour Meal History. List the foods you ate in the 3 days before your symptoms started. If you got sick in the morning, start your food history (Day 1) with the day before you got sick. If you got sick in the afternoon or evening, start your food history (Day 1) with the same day you got sick. Please include approximate location of meal and address for restaurants.

Day 1 (24 hours before you got sick)
Day 2 (48 hours before you got sick)
Day 3 (72 hours before you got sick)
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Contact Us

311 E. Alcott St.
Kalamazoo, MI 49001

269-373-5210
269-373-5333 (FAX)
269-373-5200 (HCS main line)
E-Mail

Hours

8:00 a.m. to 5:00 p.m.
(Closed 12:00 p.m. to 1:00 p.m.)
Monday thru Friday

       

Programs


Kalamazoo County Health & Community Services is committed to providing equitable, culturally competent care to all individuals served, regardless of race, age, sex, color, national origin, religion, height, weight, marital status, political affiliation, sexual orientation, gender identity, or disability. 

Links to external sites do not constitute endorsements by Kalamazoo County.