Food Safety and Lodging Complaint

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If you choose to remain anonymous, please know that we understand your desire for privacy and you may skip the "Your Contact Information" section below. However, we sometimes have questions about the complaints we investigate. If we are unable to contact you, it could slow or stop our investigation.

If you choose to know the outcome of your complaint, please complete the "Your Contact Information" section below so that we may reach you if we have questions. This will also allow us to report back to you the outcome of our investigation.

Your Contact Information

Format example: (913) 555-1212

Food Safety and Lodging Complaint

Required fields are marked by an asterisk (*).
Format example: 12/12/2012
The incident I am reporting resulted in illness or other adverse health effects to humans, animals or plants.
Information provided may be subject to disclosure under the Kansas Open Records Act K.S.A. 45-215 et seq.
Important Note:  Please understand that this form submits the information to our database and emails the Food Safety and Lodging Program with your complaint.  It will take the system just a minute to complete the submission - Please Click the Submit Button only once.