This form is only for people who work in the food industry or in an official agency

If you don't work in a food business and want to complain about bad food or a business with bad food safety practices, you should use our Make a Complaint form.

Fields marked with * are mandatory.

Name *

Position *

Organisation *

Address *

Direct telephone

Out of hours telephone

Email *

Send to a colleagues email

entering multiple emails, please separate with a ;

Section 1: Details of Hazard

Description of hazard *

Date hazard was identified

How hazard was identified

Details of any associated illness

Section 2: Details of Food

Product name (on label)

Brand name

Food type

Does food require cooking prior to consumption?

Is it an ambient, chilled or frozen food?

Lot/Batch number

Durability Details (Use by/Best Before date)

Identification marks/stamps/ premises approval number

Date of Production (if known)

Quantity of Food Implicated (if known)

Was the food sold loose, or pre-packed?

Details of Packaging (pack size/type etc.)

Any other relevant labelling information

Note: If possible, please email a picture or copy of the product label to foodincidents@fsai.ie.

Section 3: Details of Traceability

Manufacturer name and address

Retailer name and address

Supplier name and address

Importer name and address

Known distribution

Has the food been exported (including to Northern Ireland)? Give details?

Country of Origin

Section 4: Details of Testing

Was any testing carried out?

Section 5: Details of Action Taken

Details of action taken such as: trade withdrawal, customer recall, point-of-sale notice, press advertisement, etc.

Note: Please email a copy of the notice(s) to foodincidents@fsai.ie.

Summary of any contact with other agencies / organisations / retailers / manufacturers / distributors

Details of individuals which were contacted including email address, phone numbers.

Section 6: Details of Other Information

Any other details known relevant to the incident.

Note: When you submit this form it is sent to foodincidents@fsai.ie. The FSAI Food Incidents team will acknowledge receipt. If no acknowledgment is forthcoming please telephone FSAI on 01 8171300 or out of hours, in an emergency, please telephone 01 685 6555.