Title Page
Event Communication Log
-
What is the date?
-
Company or Organization?
-
Contact Person
-
How was contact made?
-
Recall Team Member Contacted
-
Copy On File
-
Reason for Recall/Description of Issue
Complaint Investigation
- Add an Investigation
-
Complaint Number
-
Complaint Date
-
How did you become aware of the problem/complaint?
-
What is the source of the problem (human error, equipment malfunction, etc.)?
Affected Products (enter for all affected products)
-
Product Name
-
Size
-
Package Code
-
UPC
-
Corrective Actions Taken?
-
Manufacturer Contacted
-
Company Name
-
Company Contact Name
-
Date & Time Contacted
-
Regulatory Agency Contacted
-
Agency Name
-
Agency Phone Number
-
Agency Contact Person
-
Date & Time Reported
-
Completed By (name)
Consumer Complaint Form
- Enter a Consumer Complaint
-
What is the complaint number?
-
What is the complaint type?
-
Customer Name?
-
Customer Phone Numbers
-
Address
-
City
-
Province/State
-
Postal Code/Zip Code
-
Email Address
-
Product Name
-
Size
-
Package Code
-
UPC
-
Location Purchased
-
Date Purchased
-
Date Consumed
-
How was the product stored?
-
Nature of the issue?
- Foreign Object
- Off Flavour
- Unsatisfactory Flavour
- Packaging
- Illness or Injury
- Allergic Reaction
- other
-
Please Specify
-
How many people have consumed the product and their ages?
-
Any Additional Information?
-
Has the customer seen a doctor?
-
Provide details
-
Has the customer spoken to Public Health?
-
Provide Details
-
Has the customer gone to the Hospital?
-
Provide Details
-
Has the customer contacted a Regulatory Agency?
-
Provide Details
-
Completed by (name)
Distributor Recall Procedure Checklist
- Recall Identification
-
Check here for a Mock Recall
-
Recall Date & Time
-
Person made responsible for the Recall
-
What activity led the Recall?
-
Recall Team Assembled (give names, responsibilities and contact information)
-
All products affected by Recall Identified?
-
Supplier Contacted?
-
Supplier Name?
-
Supplier Contact Name?
-
Date & Time Contacted
-
Regulatory Agency Contacted?
-
Agency Contacted?
-
Contact Name?
-
Date & Time Contacted
-
All Products Affected Segregated in Warehouse?
-
Date & Time Verified
-
All affected customers identified and notified?
-
Give Date & Time Notification Completed
-
How were customers contacted?
-
Are all Recalled Products Accounted For?
-
Give Date & Time Completed
-
What is the Disposition Plan for all segregated product?
-
When is the Disposition Plan expected to be complete
-
Has the Root Cause of the Recall been identified and corrected?
-
Describe the Action Plan
-
Recall Completed by
-
On this date
