301 Moody Ave. S.W., Carrollton, OH 44615 330-627-4866 Confidential Fax 330-627-3040

FOOD FACILITY COMPLAINT FORM / REPORT FOODBORNE ILLNESS

In order to investigate a food borne illness/ food facility complaint, our department needs the following information. Please fill out this form to the best of your ability.

If different from above:
*This document is considered public record. If you wish to remain anonymous, you do not have to fill out the info below.