Employee List Form - Current Employees (Cifor Foodborne Illness Response)

cIFOR FOODBORNE ILLNESS RESPONSE

TOOL 5 - EMPLOYEE LIST FORM

Purpose:

To identify all current and past employees

Instructions:

To be completed by Food Establishment.

who worked at the Food Establishment to assist in

information collection by Health/Regulatory Authori-

ties and for the Food Establishment Owner/Operator/

Manager’s use.

Owner/Operator/Manager during the period

from _____/______/______ (mm/dd/yy)

_____/______/______ (mm/dd/yy)

(Time frame to be designated by the Regulatory/Health Authority)

Food Establishment Name:

Address:

Food Establishment Contact:

Phone Number:

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Parent category: Business