200 W. Front St.
Bloomington, IL 61701
Individuals are required to provide information about their illness and eating/drinking habits as part of a foodborne illness investigation. Please answer the following questions to the best of your knowledge.
Date of Birth
Did anyone else in your party become ill?
Date suspected meal consumed:
Onset of symptoms date:
Which of the following symptoms did you experience? (Check all that apply)
Did you call or see a physician?
Has a stool culture been done?
For further information, please contact Personal Health Services by calling (309) 888-5435, option 3.