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Food Safety Complaint Form


 
 
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Food Safety Complaint Form

Please fill out as much of the information as you are able and feel comfortable providing us. Remember, the more information you provide us, the better able we will be to assist you.
Asterisks (*) denote required fields
Date of visit
Name of establishment*


Street address*
ZIP code

Please Note: this form is ONLY for food establishments within the City limits of Kansas City, Mo. If you have complaints about an establishment within the Metro area, please see our list of area Health Departments. If you have complaints about a food establishment outside of the Metro area, please contact the Health Department nearest that establishment.
 
Describe your concern or complaint*


Your name
Your e-mail (to hear back from us by e-mail)
Your phone (to hear back from us by phone)
Your city, state and ZIP code


Thank you for expressing your concern to us. The City of Kansas City, Mo., Health Department is dedicated to promoting, preserving and protecting a healthy living and working environment in Kansas City, Mo. We will take action to investigate your concern and correct any problems we find.

  

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