University of Rochester
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Environmental Health & Safety
Sanitarian's Office Complaint Form

INSTRUCTIONS:   Please complete this form if you have concerns about food related issues or sanitation issues anywhere at the University of Rochester. Once you have completed the form, click on the "Submit" button at the bottom and the information will be sent directly to the University's Sanitarian's Office.

Examples of complaints that will be investigated:

Food Related - Suspected foodborne illness; foreign object(s) in food; poor foodhandling practices; unsanitary conditions in food areas; pests in food areas

Non-Food Related - Unclean/unsanitary conditions in restrooms, patient treatment areas or waste storage areas; public health issues such as drinking water concerns, sewage backups, pest infestations, improper medical waste handling

Type of Complaint:

    Food Related
    Non-Food Related

Identifying Information:
Name:
University Affiliation: Staff       Student       Visitor      
Department (if UofR employee):   
Title:
Contact Phone Number:
E-mail address:
Do you wish your name to be kept confidential? Yes No

Complaint Information:
Complaint Location:

Date of incident:
Time of incident:

Nature of Complaint:



QUESTIONS? Contact the University's Sanitarian's Office at (585) 275-3241 or e-mail EH&S Questions.

This page last updated 8/27/2009.