FDACS Feed Regulatory Program
Activity Guidance
Document #:
SOP-FS-3
SOP-FS-5
FIRST CONTACTED BY:
Name:
Phone Number/Email:
Date:
Phone Number/Email:
Date:
Street Address:
City:
State
Zip:
Location
Please describe what happened. Be as detailed as possible
Manufacturer:
Place of Purchase:
Date of Purchase
Lot Number/Best Buy Date
Amount Purchased
Label or Bag
Sales Invoice/ Receipt Details
Amount of Product Remaining
Date Discontinued Feeding
PRODUCT INFORMATION:
COMPLAINANT:
Name
COMPLAINT:
Date of incident or situation
Revision#:1.0
Page 1 of 2
Title: Consumer Feed Complaint Form
Effective Date: 03/13/2019
Brand Name
Consumer Feed Complaint Form
DIAGNOSTICS:
Species of Animal
Yes
No
Number of Animals Affected
Vet Consulted?
Yes
No
Vet Contact Information
Has there been a diagnosis
of illness?
Describe signs of sickness
Other feeds or treats used at time of sickness
Medications used at time of sickness
FDACS SAMPLES:
This form is intended to be used as an aid in gathering information regarding a complaint related to animal feed. The quantity and quality of the
information gathered may vary with complaint.
Illness or Death
Yes
No
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