University of North Texas

University of North Texas

Guest

University of North Texas

Foodborne Illness Report Form

NOTE: seek medical care immediately if you have any of the following symptoms:

  • Bloody diarrhea
  • Diarrhea that lasts more than 3 days
  • High fever (temperature over 102°F)
  • Vomiting so often that you cannot keep liquids down
  • Signs of dehydration, which include not urinating (peeing) much, a dry mouth and throat, feeling dizzy when standing up
  • See your doctor if you are pregnant and have a fever and other flu-like symptoms.
  • Some mild infections can cause problems with pregnancy.


STUDENTS - call the Student Health and Wellness Center at 940-565-2333

This form is used to report a suspected case of foodborne illness ("food poisoning") on the UNT campus. In order to investigate your report, this form will collect information regarding the food that you ate, your symptoms, and any medical care you received. This information will help us determine if your symptoms are related to foodborne illness. UNT takes food safety very seriously, and we are committed to the protection of food consumers on our campus.


Your information is kept confidential, and only shared with UNT staff members directly involved in investigating this case. If our investigation finds that you had a foodborne illness considered to be a Notifiable Condition in the state of Texas, your case information will be reported to Denton County Public Health. If you have any questions about this form, please email EHS@unt.edu


Note: If this is a workers compensation claim, contact your supervisor within 24 hours to complete additional paperwork.

Reporter Info

* Required
* Required
* Required
* Required

Location

* Required

    Exact Location

    Loading…

    General Questions

    * Required

    Food Consumed

    Add Supporting Documents

    Add files to upload as supporting documentation along with your incident report.