Adams County Health Department – Environmental Health
4430 South Adams County Pkwy Suite 200, Brighton CO 80601 | Visit Official Website

File a Complaint

Please fill out the form below and click "Submit" at the bottom of the screen.

Thank you for submitting this information. We will follow-up on this as soon as possible.

Oops! Something went wrong while submitting the form.

{"allowAdd":"YES","allowTimeActivity":"","src":"Complaints","singular":"Complaint","doRequireParent":"NO","pkey":"complaintsID","defaultParentFormID":"","pullParentPanelData":"","addToPrintableName":"","allowClone":"","allowCopy":"NO","icon":"chatting7.png","schedulerEvents":"none","dsn":"local","plural":"Complaints","updateAssignmentsOnChange":"","doAutoSave":"YES","isDashboard":"NO","allowAssignment":"YES","allowSaveAndAdd":"","validation":{"entries":[]},"showHistory":"YES","myhdLogic":{"questionnaireSettings":{"emailSubject":"You have a new {questionnaire.singular}","parentSrc":"","frequency":1,"parentPkey":"","timeRange":{"start":"7:00 AM","end":"7:00 PM"},"triggerFields":[],"emailContent":"Hi {userRecord.firstName}, a new {questionnaire.singular} is ready for you to submit. {url}","textContent":"Hi {userRecord.firstName}, a new {questionnaire.singular} is ready for you to submit. {url}","parentFormID":"","frequencyUnit":"daily"},"singular":"Complaint","instructions":"Please fill out the form below and click \"Submit\" at the bottom of the screen.","emailNotificationMessage":"Hi {contact.firstName},\n\nA new {form.singular} has been submitted from MyHD:\n\nDetails:\n{record.CMcomplaintDetails}\n\nComplaint ID: {record.complaintNumber}","textNoficationMessage":"Hi {contact.firstName}, a new {form.singular} has been submitted from My Health Department.com. Refer to {record.complaintID}","notificationConditions":[],"title":"File a Complaint","settings":{"contactList":[{"userID":"3276A926-AF04-41D6-A433-4507DA208A7B","method":"Email","type":"user"},{"userID":"09E88E31-6250-449B-BF24-B9F6980B1C0F","method":"Email","type":"user"},{"userID":"5A07E872-D6BE-41E9-B5C7-6DE4A1965661","method":"Email","type":"user"},{"userID":"BD87574B-B99A-43D7-A0E5-090F054BB2F2","method":"Email","type":"user"},{"userID":"07845B55-9808-496B-84C2-42B0DF4E7D0D","method":"Email","type":"user"}],"includeFields":["type","outbreakNumber","complaintDetails","complainantAnon","complainantFirstName","complainantLastName","complainantPhone","complainantEmail","complaintantAddress","suspectMealDate","suspectMealTime","suspectMealLocation","suspectMeal","numberOfParty","numberOfPeopleIll","groupContact","groupPhone","unusualMealThings","notesInvestigator","CMcomplaintDetails","CMcomplainantAnon","CMcomplainantFirstName","CMcomplainantLastName","CMcomplainantPhone","CMEmail","CMcomplaintType","CMOther","Age","Gender","Occupation","SuspectRestaurantEvent","AddressLocationofFBI","DateEaten","TimeEaten","NumInParty","MealConsumed","OnsetDate","OnsetTime","SymptomsResolved","StoppedDate","StoppedTime","IncubationTime","IncubationTime6859","IncubationTime3796","SignsandSymptoms","DescribeSymptoms","DoctorVisited","DateVisited","PhysicianPhone","TypeofSpecimensTaken","OtherSpecimenType","Diagnosis","MealsConsumedDayofIllness","MealsConsumedDayofIllness7251","MealsConsumedDayofIllness5813","LocationofComplaint","UploadInstr"],"allowFileUploads":"NO","expose":"YES","flags":[{"field":"CMdateReceived","value":"{now}"},{"field":"CMhowReceived","value":"Website"}],"type":"Public","requireMinimumFileUploads":"","fieldSettings":{"LocationofComplaint":{"label":"","defaultValue":"","isFormValidator":"NO","searchResultsLayout":{"columns":[]},"formValidation":{"fields":[]},"overridesEnabled":"YES","overrideConfigs":{"properties":{"required":"NO","id":"LocationofComplaint","label":"Location of Complaint","placeholder":"Street Address City, State, Zip"},"type":"text","subfields":[],"required":"NO"}},"UploadInstr":{"label":"","defaultValue":"","isFormValidator":"NO","searchResultsLayout":{"columns":[]},"formValidation":{"fields":[]},"overridesEnabled":"YES","overrideConfigs":{"properties":{"id":"UploadInstr","label":"UploadInstr","hideField":"YES"},"type":"infobox","subfields":[],"default":"Attachments/Pictures\n\nIf you have pictures or documents you would like to add to your complaint, please send those separately by email to environmentalhealthinspections@adcogov.org. In the subject line, please provide the business name or property address so we can properly connect the files to the complaint. Thank you."}}},"fees":[],"maxSummaryColumns":8},"submittedMessage":"Thank you for submitting this information. We will follow-up on this as soon as possible.","subForms":[],"plural":"Complaints","path":"file-a-complaint"},"doShowHistoryViews":"YES","majorLabelDescription":"","allowAttach":"YES","doChangeLog":"YES","assignmentLogic":{"logic":[],"notificationType":"email","notificationText":"","notificationMessage":"The following complaint document has been referred to you: Complaint Number: {RECORD.complaintNumber} Complaint Type: {RECORD.complaintType} Date Received: {FORMATTERS.DATE.RECORD.dateReceived} Investigate Within: {RECORD.investigateWithin}"},"version":"1.0","exportConfig":{"lkp":[{"alias":"Establishment_Manager","from":"establishmentID","to":"This_Form","type":"left","key":"Establishment","lkpto":"","on":"establishmentID"},{"alias":"Address_Manager","from":"addressID","to":"This_Form","type":"left","key":"Address","lkpto":"","on":"addressID"},{"alias":"User_Manager_Assigned","from":"userID","to":"This_Form","type":"left","key":"users","lkpto":"","on":"recordAssignedToUserID"},{"filter":"","alias":"Permit_Manager","from":"parentFormID","to":"Establishment_Manager","row":0,"type":"left","key":"Permit","lkpto":"","dsn":"","on":"establishmentID"},{"filter":"","alias":"User_Manager_Received_BY","from":"userID","to":"This_Form","row":0,"type":"left","key":"users","lkpto":"","dsn":"","on":"receivedByUserID"}],"columns":[{"primaryCol":"undefined","src":"Complaints","format":"date","schedulerDesc":"undefined","isLocation":"undefined","label":"Date Received","schedulerName":"undefined","majorLabel":"undefined","out":"{dateReceived}","mask":"","filterable":true,"hideFromOutput":false},{"primaryCol":"undefined","src":"Complaints","format":"","schedulerDesc":true,"isLocation":"undefined","label":"Complaint Type","schedulerName":"undefined","majorLabel":"undefined","out":"{type}","mask":"","filterable":true,"hideFromOutput":false},{"primaryCol":"undefined","src":"Complaints","format":"","schedulerDesc":"undefined","isLocation":"undefined","label":"Status","schedulerName":"undefined","majorLabel":"undefined","out":"{status}","mask":"","filterable":true,"hideFromOutput":false},{"primaryCol":"undefined","src":"Complaints","format":"","schedulerDesc":"undefined","isLocation":"undefined","label":"Investigate Within","schedulerName":"undefined","majorLabel":"undefined","out":"{investigateWithin}","mask":"","filterable":true,"hideFromOutput":false},{"src":"Complaints","format":"","alias":"This_Form","label":"Complaint ID","mask":"","out":"{complaintID}","hideFromOutput":false},{"src":"Permit","format":"","alias":"Permit_Manager","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","filterable":"undefined","mask":"","out":"{permitName}","primaryCol":"undefined","label":"Name","hideFromOutput":false},{"src":"Address","format":"","alias":"Address_Manager","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","filterable":"undefined","mask":"","out":"{addressLine1} {addressLine2} {city}, {state} {zip} ","primaryCol":"undefined","label":"Address","hideFromOutput":false},{"src":"users","format":"","alias":"User_Manager_Assigned","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","filterable":true,"mask":"","out":"{firstName} {lastName}","primaryCol":"undefined","label":"Assigned To","hideFromOutput":false},{"src":"users","format":"","alias":"User_Manager_Received_BY","label":"Received By","mask":"","out":"{User_Manager_Received_BYfirstName} {User_Manager_Received_BYlastName}","hideFromOutput":false},{"src":"Complaints","format":"","alias":"This_Form","label":"Referred","mask":"","out":"{Referred}","hideFromOutput":false,"filterable":true}]},"title":"Complaint Manager","allowExport":"YES","allowEdit":"YES","configureAssignmentLogic":{"logic":[]},"allowDelete":"","showConversationPanel":"","disableRecordPreview":"","allowQuickEdit":"YES","formID":"3CA28874-348A-4DFE-A7F8-92DDBAB914B0","listPageConfig":{"lkp":[{"alias":"Address_Manager","from":"addressID","to":"This_Form","type":"left","key":"Address","lkpto":"","on":"addressID"},{"alias":"AssignedTo","from":"userID","to":"This_Form","type":"left","key":"users","lkpto":"","on":"recordAssignedToUserID","multiFrom":false,"multiTo":false},{"filter":"","alias":"Permit_Manager","from":"permitID","to":"This_Form","row":0,"type":"left","key":"Permit","lkpto":"","dsn":"","on":"permitID","multiFrom":false,"multiTo":false},{"filter":"","alias":"EstablishmentLKP","from":"establishmentID","to":"Permit_Manager","row":0,"type":"left","key":"Establishment","lkpto":"","dsn":"","on":"parentFormID","multiFrom":false,"multiTo":false},{"filter":"","alias":"establishment_address","from":"addressID","to":"EstablishmentLKP","row":0,"type":"left","key":"Address","lkpto":"","dsn":"","on":"parentFormID","multiFrom":false,"multiTo":false},{"filter":"","alias":"ReceivedBy","from":"userID","to":"This_Form","row":0,"type":"left","key":"users","lkpto":"","dsn":"","on":"CMreceivedByUserID","multiFrom":false,"multiTo":false},{"alias":"ClosedBy","key":"users","from":"userID","to":"This_Form","on":"userID","filter":"","row":0,"lkpto":"","type":"left","dsn":"","multiFrom":false,"multiTo":false},{"alias":"ComplainantAddress","key":"Address","from":"addressID","to":"This_Form","on":"complaintantAddressID","filter":"","row":0,"lkpto":"","type":"left","dsn":"","multiFrom":false,"multiTo":false},{"alias":"PermitType","key":"CFG_Permit_Type","from":"cfg_permit_typeID","to":"Permit_Manager","on":"cfg_permit_typeID","filter":"","row":0,"lkpto":"","type":"left","dsn":"","multiFrom":false,"multiTo":false},{"alias":"OwnerLookup","key":"Contacts","from":"contactsID","to":"Permit_Manager","on":"rdplookupID","filter":"{contactType} LIKE '%Owner%'","row":0,"lkpto":"permitID","type":"left","dsn":"","multiFrom":false,"multiTo":false},{"alias":"OwnerAddress","key":"Address","from":"addressID","to":"OwnerLookup","on":"addressID","filter":"","row":0,"lkpto":"","type":"left","dsn":"","multiFrom":false,"multiTo":false}],"columns":[{"src":"Complaints","format":"","alias":"This_Form","label":"Complaint ID","mask":"","out":"{complaintNumber}","hideFromOutput":"NO"},{"src":"Permit","format":"","alias":"Permit_Manager","label":"Permit Name","mask":"","out":"{permitName}","hideFromOutput":"NO"},{"mask":"","out":"{establishmentName}","alias":"EstablishmentLKP","src":"Establishment","format":"","label":"Facility Name","hideFromOutput":"YES","nonsearchable":true},{"mask":"","out":"{addressLine1} {addressLine2} {city} {state} {zip}","alias":"establishment_address","src":"Address","format":"","label":"Establishment Address","hideFromOutput":"NO"},{"mask":"","out":"{Address_ManageraddressLine1} {Address_ManageraddressLine2} {Address_Managercity} {Address_Managerstate} {Address_Managerzip}","alias":"Address_Manager","src":"Address","format":"","label":"Non Permitted Address","hideFromOutput":"NO","alwaysIncludeAlias":"YES"},{"mask":"","out":"{CMcomplainantFirstName} {CMcomplainantLastName}","alias":"This_Form","src":"Complaints","format":"","label":"Complainant Name","hideFromOutput":"NO","filterable":true},{"mask":"","out":"{firstName} {lastName}","alias":"ReceivedBy","src":"users","format":"","label":"Received By","hideFromOutput":"NO","filterable":true},{"src":"Complaints","format":"date","alias":"This_Form","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","out":"{CMdateReceived}","mask":"","filterable":true,"primaryCol":"undefined","label":"Date Received","hideFromOutput":"NO"},{"src":"Complaints","format":"","alias":"This_Form","label":"How Received","mask":"","out":"{CMhowReceived}","hideFromOutput":"NO","filterable":true},{"src":"Complaints","format":"","alias":"This_Form","schedulerDesc":true,"isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","out":"{CMcomplaintType}","mask":"","filterable":true,"primaryCol":"undefined","label":"Complaint Type","hideFromOutput":"NO"},{"src":"Complaints","format":"","alias":"This_Form","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","out":"{CMstatus}","mask":"","filterable":true,"primaryCol":"undefined","label":"Status","hideFromOutput":"NO"},{"src":"Complaints","format":"","alias":"This_Form","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","out":"{CMinvestigateWithin}","mask":"","filterable":false,"primaryCol":false,"label":"Investigate Within","hideFromOutput":"YES","nonsearchable":true},{"src":"users","format":"","alias":"AssignedTo","schedulerDesc":"undefined","isLocation":"undefined","schedulerName":"undefined","majorLabel":"undefined","filterable":true,"mask":"","out":"{AssignedTofirstName} {AssignedTolastName}","primaryCol":"undefined","label":"Assigned To","hideFromOutput":"NO","alwaysIncludeAlias":"YES"},{"mask":"","out":"{CMdateComplaintClosed}","alias":"This_Form","src":"Complaints","format":"date","label":"Date Closed","hideFromOutput":"NO","filterable":true},{"mask":"","out":"{ClosedByfirstName} {ClosedBylastName}","alias":"ClosedBy","src":"users","format":"","label":"Closed By","hideFromOutput":"YES","alwaysIncludeAlias":"YES","nonsearchable":true},{"mask":"","out":"{ComplainantAddressaddressLine1} {ComplainantAddressaddressLine2} {ComplainantAddresscity} {ComplainantAddressstate} {ComplainantAddresszip}","alias":"ComplainantAddress","src":"Address","format":"","label":"Complainant Address","hideFromOutput":"NO","alwaysIncludeAlias":"YES","filterable":true},{"mask":"","out":"{permitType}","alias":"PermitType","src":"CFG_Permit_Type","format":"","label":"Permit Type","hideFromOutput":"NO"},{"mask":"","out":"{PMFacilityPhone}","alias":"Permit_Manager","src":"Permit","format":"phone","label":"Permit Phone","hideFromOutput":"YES"},{"mask":"","out":"{OwnerLookuporganization} {OwnerLookupfirstName} {OwnerLookuplastName}","alias":"OwnerLookup","src":"Contacts","format":"","label":"Owner Name","hideFromOutput":"NO","alwaysIncludeAlias":"YES"},{"mask":"","out":"{OwnerAddressaddressLine1} {OwnerAddressaddressLine2} {OwnerAddresscity} {OwnerAddressstate} {OwnerAddresszip}","alias":"OwnerAddress","src":"Address","format":"","label":"Owner Address","hideFromOutput":"NO","alwaysIncludeAlias":"YES"},{"mask":"","out":"{CTMstatus}","alias":"OwnerLookup","src":"Contacts","format":"","label":"Owner Status","hideFromOutput":"NO","filterable":true}],"listInfoBox":{"infoBoxType":"","infoBox":"alert","infoText":""}},"dataEntryConfig":{"panels":[{"form":"Complaints_FBI","layout":{"columns":[{"src":"Complaints_FBI","format":"date","sortBy":"","label":"Date Received","outOverride":"","hideFromOutput":false,"mask":"","out":"{dateReceived}"},{"format":"","src":"Complaints_FBI","label":"Complainant Name","hideFromOutput":false,"mask":"","out":"{complainantName}"}]},"isChild":true}],"form":[{"properties":{"group":"Complaint Details","label":"Complaint Type","id":"CMcomplaintType","maxlength":500,"size":"5","useTypeAhead":true},"required":true,"options":[{"text":"Air Quality, Indoor","value":"Air Quality, Indoor"},{"text":"Air Quality, Outdoor","value":"Air Quality, Outdoor"},{"text":"Animal Bites - Animal to Animal","value":"Animal Bites - Animal to Animal"},{"text":"Animal Bites - Animal to Human","value":"Animal Bites - Animal to Human"},{"text":"Body Art","value":"Body Art"},{"text":"Child Care","value":"Child Care"},{"text":"Foodborne Illness","value":"Foodborne Illness"},{"text":"Housing","value":"Housing"},{"text":"Meth Lab","value":"Meth Lab"},{"text":"Mold","value":"Mold"},{"text":"Other","value":"Other"},{"text":"OWTS/Septic System","value":"OWTS/Septic System"},{"text":"Private Drinking Water Well","value":"Private Drinking Water Well"},{"text":"Private Water System","value":"Private Water System"},{"text":"Public Drinking Water Systems","value":"Public Drinking Water Systems"},{"text":"Public Accommodations","value":"Public Accommodations"},{"text":"Recreational Water","value":"Recreational Water"},{"text":"Retail Food","value":"Retail Food"},{"text":"School","value":"School"},{"text":"Solid Waste/Trash","value":"Solid Waste/Trash"},{"text":"Spills","value":"Spills"},{"text":"Vector Control","value":"Vector Control"}],"type":"select","default":"","dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true,"logic":[]},{"properties":{"group":"Complaint Details","label":"Other","id":"CMOther","maxlength":500},"type":"text","logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]},{"type":"require","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]}],"subfields":[],"dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true},{"properties":{"required":"NO","id":"LocationofComplaint","label":"Location of Complaint","placeholder":"Street Address City, State, Zip"},"type":"text","subfields":[],"required":"NO"},{"properties":{"group":"Complaint Details","label":"Complaint Details","id":"CMcomplaintDetails"},"required":true,"type":"textarea","default":"","dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":"MAX","dbNullable":true},{"properties":{"label":"Is Anonymous?","id":"CMcomplainantAnon","maxlength":500},"required":true,"options":[{"text":"YES","value":"YES"},{"text":"NO","value":"NO"}],"logic":[],"type":"select","dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true},{"properties":{"group":"Complainant","label":"First Name","id":"CMcomplainantFirstName","maxlength":500},"logic":[{"target":"group","col":"","inputType":"input,select","src":"","field":"CMcomplainantAnon","calculationType":"","value":"NO","targetValue":"","validationType":"","filterType":"field","valueAction":"===","idOverride":"","rules":[],"type":"show"},{"target":"group","col":"","inputType":"input,select","src":"","field":"CMcomplainantAnon","calculationType":"","value":"YES","targetValue":"","validationType":"","filterType":"field","valueAction":"===","idOverride":"","rules":[],"type":"hide"}],"type":"text","default":"","dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true},{"properties":{"group":"Complainant","label":"Last Name","id":"CMcomplainantLastName","maxlength":500},"logic":[],"type":"text","default":"","dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true},{"properties":{"group":"Complainant","label":"Phone","id":"CMcomplainantPhone","maxlength":500},"logic":[],"type":"phone","dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true},{"properties":{"group":"Complainant","label":"Email","id":"CMEmail","maxlength":500},"type":"text","logic":[],"subfields":[],"dbType":"VARCHAR","dbUnicode":false,"dbMaxLength":500,"dbNullable":true},{"properties":{"maxlength":"500","id":"Age","group":"Complainant~expanded","label":"Age"},"type":"text","subfields":[],"logic":[{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"show","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}]},{"properties":{"id":"Gender","label":"Gender","group":"Complainant~expanded"},"type":"select","subfields":[],"options":[{"text":"Male","value":"Male"},{"text":"Female","value":"Female"},{"text":"Non-Binary","value":"Non-Binary"},{"text":"Choose not to identify","value":"Choose not to identify"}],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}]},{"properties":{"maxlength":"500","id":"Occupation","label":"Occupation","group":"Complainant~expanded"},"type":"text","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}]},{"properties":{"id":"SuspectRestaurantEvent","label":"Suspect Restaurant/Event","group":"Foodborne Illness Details~expanded"},"type":"textarea","subfields":[],"dbMaxLength":"MAX","logic":[{"type":"show","target":"group","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"group","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}]},{"properties":{"maxlength":"500","id":"AddressLocationofFBI","group":"Foodborne Illness Details~expanded","label":"Address/Location"},"type":"text","subfields":[],"logic":[]},{"properties":{"id":"DateEaten","label":"Date Eaten","group":"Foodborne Illness Details~expanded"},"type":"date","subfields":[]},{"properties":{"id":"TimeEaten","label":"Time Eaten","group":"Foodborne Illness Details~expanded"},"type":"time","subfields":[]},{"properties":{"id":"NumInParty","label":"Number of People in Party","group":"Foodborne Illness Details~expanded"},"type":"number","subfields":[],"dbPrecision":"18,6"},{"properties":{"maxlength":"500","id":"MealConsumed","label":"Meal Consumed","group":"Foodborne Illness Details~expanded"},"type":"text","subfields":[],"logic":[{"idOverride":"","type":"show","target":"group","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","value":"Foodborne Illness","targetValue":"","valueType":"input","rules":[]},{"idOverride":"","type":"hide","target":"group","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","value":"Foodborne Illness","targetValue":"","valueType":"input","rules":[]}]},{"properties":{"id":"OnsetDate","label":"Onset Date","group":"Foodborne Illness Details~expanded"},"type":"date","subfields":[]},{"properties":{"id":"OnsetTime","label":"Onset Time","group":"Foodborne Illness Details~expanded"},"type":"time","subfields":[]},{"properties":{"id":"SymptomsResolved","label":"Symptoms Resolved","group":"Foodborne Illness Details~expanded"},"type":"select","subfields":[],"options":[{"text":"Yes","value":"Yes"},{"text":"No","value":"No"}]},{"properties":{"id":"StoppedDate","label":"Stopped Date","group":"Foodborne Illness Details~expanded"},"type":"date","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"SymptomsResolved","valueAction":"===","idOverride":"","inputType":"input,select","value":"Yes","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"SymptomsResolved","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Yes","targetValue":"","rules":[]}]},{"properties":{"id":"StoppedTime","label":"Stopped Time","group":"Foodborne Illness Details~expanded"},"type":"time","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"SymptomsResolved","valueAction":"===","idOverride":"","inputType":"input,select","value":"Yes","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"SymptomsResolved","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Yes","targetValue":"","rules":[]}]},{"properties":{"id":"IncubationTime","label":"Incubation Time","group":"Foodborne Illness Details~expanded"},"type":"number","subfields":[],"suffix":"Days"},{"properties":{"id":"IncubationTime6859","label":"Incubation Time","group":"Foodborne Illness Details~expanded"},"type":"number","subfields":[],"suffix":"Hours"},{"properties":{"id":"TypeofSpecimensTaken","label":"Type of Specimens Taken","group":"Clinical Data~expanded"},"type":"checkbox","subfields":[],"options":[{"text":"Blood","value":"Blood"},{"text":"Stool","value":"Stool"},{"text":"Urine","value":"Urine"},{"text":"Other","value":"Other"}]},{"properties":{"id":"IncubationTime3796","label":"Incubation Time","group":"Foodborne Illness Details~expanded"},"type":"number","subfields":[],"suffix":"Minutes"},{"properties":{"id":"SignsandSymptoms","label":"Signs and Symptoms","group":"Foodborne Illness Details~expanded"},"type":"checkbox","subfields":[],"options":[{"text":"Body Aches","value":"Body Aches"},{"text":"Bloody Diarrhea","value":"Bloody Diarrhea"},{"text":"Chills","value":"Chills"},{"text":"Diarrhea","value":"Diarrhea"},{"text":"Fever","value":"Fever"},{"text":"Headache","value":"Headache"},{"text":"Nausea","value":"Nausea"},{"text":"Stomach Cramps","value":"Stomach Cramps"},{"text":"Other","value":"Other"},{"text":"Vomiting","value":"Vomiting"}]},{"properties":{"id":"DescribeSymptoms","label":"Describe Symptoms","group":"Foodborne Illness Details~expanded"},"type":"text","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"SignsandSymptoms","valueAction":"indexOf","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"SignsandSymptoms","valueAction":"notIndexOf","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]}]},{"properties":{"id":"DoctorVisited","label":"Was a doctor or other healthcare provider visited?"},"type":"select","subfields":[],"options":[{"text":"Yes","value":"Yes"},{"text":"No","value":"No"}],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}]},{"properties":{"id":"DateVisited","label":"Date Visited","group":"Clinical Data~expanded"},"type":"date","subfields":[],"logic":[{"type":"show","target":"group","validationType":"","calculationType":"","src":"","filterType":"field","field":"DoctorVisited","valueAction":"===","idOverride":"","inputType":"input,select","value":"Yes","targetValue":"","rules":[]},{"type":"hide","target":"group","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"DoctorVisited","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Yes","targetValue":"","rules":[]}]},{"properties":{"id":"PhysicianPhone","label":"Phone","group":"Clinical Data~expanded"},"type":"phone","subfields":[]},{"properties":{"id":"OtherSpecimenType","label":"Other Specimen Type","group":"Clinical Data~expanded"},"type":"text","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"TypeofSpecimensTaken","valueAction":"indexOf","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"TypeofSpecimensTaken","valueAction":"notIndexOf","idOverride":"","inputType":"input,select","value":"Other","targetValue":"","rules":[]}]},{"properties":{"id":"Diagnosis","label":"Diagnosis","group":"Clinical Data~expanded"},"type":"text","subfields":[]},{"properties":{"id":"UploadInstr","label":"UploadInstr","hideField":"YES"},"type":"infobox","subfields":[],"default":"Attachments/Pictures\n\nIf you have pictures or documents you would like to add to your complaint, please send those separately by email to environmentalhealthinspections@adcogov.org. In the subject line, please provide the business name or property address so we can properly connect the files to the complaint. Thank you."},{"properties":{"id":"MealsConsumedDayofIllness","label":"Meals Consumed Day of Illness"},"type":"reload","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}],"childFields":[{"properties":{"id":"DayOneDate","label":"Date"},"type":"date","subfields":[],"isChild":true},{"properties":{"id":"MealDayOne","label":"Meal"},"type":"select","subfields":[],"isChild":true,"options":[{"text":"Breakfast","value":"Breakfast"},{"text":"Lunch","value":"Lunch"},{"text":"Dinner","value":""},{"text":"Other Meal","value":"Other Meal"}]},{"properties":{"id":"FoodsEatenDayOne","label":"Foods Eaten"},"type":"textarea","subfields":[],"isChild":true},{"properties":{"id":"MealDayOneTime","label":"Time"},"type":"time","subfields":[],"logic":[],"isChild":true},{"properties":{"id":"LocationMealDayOne","label":"Location"},"type":"text","subfields":[],"isChild":true},{"properties":{"id":"SuspectMeal","label":"Suspect Meal"},"type":"select","subfields":[],"options":[{"text":"No","value":"No"},{"text":"Yes","value":"Yes"}],"isChild":true}]},{"properties":{"id":"MealsConsumedDayofIllness7251","label":"Meals Consumed Day Prior to Illness"},"type":"reload","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}],"childFields":[{"properties":{"id":"DayTwoDate","label":"Date"},"type":"date","subfields":[]},{"properties":{"id":"MealDayTwo","label":"Meal"},"type":"select","subfields":[],"options":[{"text":"Breakfast","value":"Breakfast"},{"text":"Lunch","value":"Lunch"},{"text":"Dinner","value":"Dinner"},{"text":"Other","value":"Other"}]},{"properties":{"id":"FoodsEatenDayTwo","label":"Foods Eaten"},"type":"textarea","subfields":[]},{"properties":{"id":"MealDayTwoTime","label":"Time"},"type":"time","subfields":[]},{"properties":{"id":"LocationMealDayTwo","label":"Location"},"type":"text","subfields":[]},{"properties":{"id":"SuspectMealTwo","label":"Suspect Meal"},"type":"select","subfields":[],"options":[{"text":"No","value":"No"},{"text":"Yes","value":"Yes"}]}]},{"properties":{"id":"MealsConsumedDayofIllness5813","label":"Meals Consumed 2 Days Prior to Illness"},"type":"reload","subfields":[],"logic":[{"type":"show","target":"field","validationType":"","calculationType":"","src":"","filterType":"field","field":"CMcomplaintType","valueAction":"===","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]},{"type":"hide","target":"field","validationType":"","calculationType":"","src":"","col":"","filterType":"field","field":"CMcomplaintType","valueAction":"!==","idOverride":"","inputType":"input,select","value":"Foodborne Illness","targetValue":"","rules":[]}],"childFields":[{"properties":{"id":"DateDayThree","label":"Date"},"type":"date","subfields":[]},{"properties":{"id":"MealDayThree","label":"Meal"},"type":"select","subfields":[],"options":[{"text":"Breakfast","value":"Breakfast"},{"text":"Lunch","value":"Lunch"},{"text":"Dinner","value":"Dinner"},{"text":"Other","value":"Other"}]},{"properties":{"id":"FoodsEatenDayThree","label":"Foods Eaten"},"type":"textarea","subfields":[]},{"properties":{"id":"TimeMealDayThree","label":"Time"},"type":"time","subfields":[]},{"properties":{"id":"LocationDayThree","label":"Location"},"type":"text","subfields":[]},{"properties":{"id":"SuspectMealDayThree","label":"Suspect Meal"},"type":"select","subfields":[],"options":[{"text":"Yes","value":"Yes"},{"text":"No","value":"No"}]}]}]},"hsScripts":[]}