contact us

What type of feedback do you want to share?*

Please select the specific reason for your feedback:*

Injury Details

Please describe the injury you experienced (please share as much information as possible).*

When did the injury occur?*

Did you seek out medical treatment?*

Yes
No

What treatment did you receive?*

What is the name of the Doctor you saw and the address of the hospital or clinic you visited?*

Do you still have a sample of the product?*

Yes
No

We would like to retrieve the object, and will arrange for Purolator to come pick up the object. Best date and time of day for pick up:*

You may also send us an image of the foreign object via the attachment tool available at the end of this online form.

Pick-up Location Address (if not the same as home address):*

Illness/Allergy Detail

Please describe the reaction or symptoms you experienced.*

What food allergies do you have?

When did the reaction/illness occur?*

Approximately how long did your symptoms last?*

What other food was consumed within 2 hours of eating the product?

Did you seek out medical treatment?*

Yes
No

What treatment did you receive?*

What is the name of the Doctor you saw and the address of the hospital or clinic you visited?*

Do you still have a sample of the product?*

Yes
No

We would like to retrieve the object, and will arrange for Purolator to come pick up the object. Best date and time of day for pick up:*

You may also send us an image of the foreign object via the attachment tool available at the end of this online form.

Pick-up Location Address (if not the same as home address):*

Foreign Material in Product Detail

Please describe the foreign material.*

Was any injury sustained from the foreign material?*

Yes
No

Did you seek out medical treatment?*

Yes
No

What treatment did you receive?*

What is the name of the Doctor you saw and the address of the hospital or clinic you visited?*

Do you still have a sample of the product?*

Yes
No

We would like to retrieve the object, and will arrange for Purolator to come pick up the object. Best date and time of day for pick up:*

You may also send us an image of the foreign object via the attachment tool available at the end of this online form.

Pick-up Location Address (if not the same as home address):*

Product Information

Brand:*

Product:*

Purchase Details

Have you purchased this product before?*

Yes
No

Purchase Location

Best Before Date*

Example: 170422KB1 (YYMMDD Plant Shift)

Contact Details

First Name*

Last Name*

Address

City

State

Zip Code

Country

Email

Phone

How May We Contact You?*

Comments

Please enter your comments and feedback below:*

Attachments

Please attach any relevant files

Drop files here or

Maximum 2MB

Mailing List

Would you like to receive updates on promotions, new product launches, recipe ideas, and special offers, or to participate in a survey from Lesley Stowe Fine Foods?*

Yes
No

Do you provide permission for Lesley Stowe Fine Foods to use comments in this form for internal or external marketing purposes, including advertising and social media?*

Yes
No

questions? comments?
we’d love to hear from you

Injury Details

Illness/Allergy Detail

Foreign Material in Product Detail

Product Information

Purchase Details

Contact Details

Comments

Attachments

Mailing List

for all media inquiries contact:

questions? comments?we’d love to hear from you

Injury Details

Illness/Allergy Detail

Foreign Material in Product Detail

Product Information

Purchase Details

Contact Details

Comments

Attachments

Mailing List

for all media inquiries contact:

questions? comments?
we’d love to hear from you