beverages. Day Meal AM/ PM Place Food Consumed (Include name, address, city/town) Day 0 Breakfast AM PM (the day Lunch AM PM of onset) Dinner AM PM Snack AM PM Day 1 Breakfast AM PM (1 day Lunch AM PM before onset) Dinner AM PM Snack AM PM Day 2 Breakfast AM PM (2 days Lunch AM PM before onset) Dinner AM PM Snack AM PM Response Details (e.g., Brand name, purchase/consumption location, product details, date of exposure) Behavioural Social Risk iPHIS character limit: 50. Factors in the 4 days prior to onset of illness asked No Yes Unknown Not Foodborne Consumption of fish (raw or cooked; for scombroid, ciguatera, and Vibrio only) Consumption of raw/undercooked shellfish
beverages. Day Meal AM/ PM Place (Include name, address, city/town) Food Consumed Day 0 (the day of onset) Breakfast AM PM Lunch AM PM Dinner AM PM Snack AM PM Day 1 (1 day before onset) Breakfast AM PM Lunch AM PM Dinner AM PM Snack AM PM Day 2 (2 days before onset) Breakfast AM PM Lunch AM PM Dinner AM PM Snack AM PM Behavioural Social Risk Factors in the 4 days prior to onset of illness Foodborne Response Details (e.g., Brand name, purchase/consumption location, product details, date of exposure) iPHIS character limit: 50. Yes No Unknown Not asked Consumption of fish (raw or cooked; for scombroid, ciguatera, and Vibrio only) Consumption of raw/undercooked shellfish