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Live Demo

See the form your residents would use

This is a real reporting form. Go ahead — fill it out and submit. It's a live demo; no data goes to any health department.

Report type
Language
Try it: use the mic icon to report by voice, or attach a photo of the meal directly in the form below.

Auto-translated for your team

Every submission is automatically converted to English — no manual translation needed, regardless of the language reported in.

One line of code to embed

Drop a single iframe tag into any county website — no developers, no special platform requirements.

Feeds outbreak detection

Every submission flows directly into DineSafe's analytics engine for real-time pattern detection and alerting.

Customizable for your jurisdiction

Brand the form with your county's name, logo, and colors. Configurable for any city, county, or state.