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How do I fill this out?

To fill out this form, gather your personal and work information, complete the required sections, and follow the submission instructions. Ensure all details are accurate and legible. Submit the form along with the necessary documents and fees.

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How to fill out the Philadelphia Food Safety Certificate Application?

  1. 1

    Gather personal and work information.

  2. 2

    Complete the required sections of the form.

  3. 3

    Ensure all details are accurate and legible.

  4. 4

    Include necessary documents and fees.

  5. 5

    Submit the form as per the provided instructions.

Who needs the Philadelphia Food Safety Certificate Application?

  1. 1

    Restaurant employees requiring a Food Safety Certificate to meet health regulations.

  2. 2

    Food truck operators needing certification to operate legally in Philadelphia.

  3. 3

    New food business hires needing certification to comply with city regulations.

  4. 4

    Current employees whose certificates are nearing expiration and require renewal.

  5. 5

    Individuals seeking replacement certificates for lost or damaged originals.

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  1. 1

    Open the PDF file in PrintFriendly's PDF editor.

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    Enter your information into the appropriate fields.

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What are the instructions for submitting this form?

To submit this form, you can either apply in person or by mail to the Philadelphia Department of Public Health, Office of Food Protection, 321 University Avenue, Philadelphia, PA 19104. If applying in person, schedule an appointment or use the drop-box available at any time. Ensure you include a copy of the course certificate, completed application form, and a money order for the applicable fee. For replacement certificates, include a statement of the reason for replacement.

What are the important dates for this form in 2024 and 2025?

No specific important dates are applicable for this form in 2024 and 2025.

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What is the purpose of this form?

The purpose of this form is to ensure that employees in the Philadelphia food industry are certified in food safety, meeting the city's health regulations. Having a certified employee is a requirement for stationary food businesses within the city. This form is used to apply for a new certificate, renew an existing one, or request a replacement for a lost or damaged certificate.

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Tell me about this form and its components and fields line-by-line.

This form includes several fields to gather personal and work-related information necessary for obtaining a Food Safety Certificate.
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  • 1. First Name: The first name of the applicant.
  • 2. Middle Initial: The middle initial of the applicant.
  • 3. Last Name: The last name of the applicant.
  • 4. Home Mailing Address: The mailing address of the applicant's home.
  • 5. Floor / Apartment Number / Location: Specific location details within the home address.
  • 6. City: The city of the applicant's home address.
  • 7. State: The state of the applicant's home address.
  • 8. Zip Code: The zip code of the applicant's home address.
  • 9. Email Address: The email address of the applicant.
  • 10. Date of Birth: The birthdate of the applicant.
  • 11. Telephone Number: The contact number of the applicant.
  • 12. Work / Establishment Name: The name of the applicant's workplace or establishment.
  • 13. Work / Establishment Address: The address of the applicant's workplace or establishment.
  • 14. Work / Establishment Zip Code: The zip code of the applicant's workplace or establishment.
  • 15. Work Telephone Number: The contact number for the applicant's workplace or establishment.
  • 16. Email Confirmation Request: Option to receive a confirmation of receipt via email.
  • 17. Mail Certificate to Home Address: Option to have the certificate mailed to the home address.
  • 18. Notify When Certificate is Ready for Pick-up: Option to be notified when the certificate is ready for pick-up.
  • 19. Send All Certificates to Work Address: Option to send all food safety certificates to the work address.

What happens if I fail to submit this form?

Failure to submit this form can result in a lack of certification for food safety within your business, leading to potential regulatory issues.

  • Non-compliance: Your business may not comply with health regulations without certified employees.
  • Operational Impact: Inability to meet certification requirements may affect your business operations.
  • Penalties: Non-compliance can lead to fines or other penalties from health authorities.

How do I know when to use this form?

Use this form when you need to obtain a new Food Safety Certificate, renew an existing one, or request a replacement.
fields
  • 1. New Certificate: Apply for a new Food Safety Certificate when starting employment in the food industry.
  • 2. Renewal: Use the form to renew your certificate if it is nearing its expiration date.
  • 3. Replacement: Request a replacement for a lost or damaged Food Safety Certificate.

Frequently Asked Question

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Use PrintFriendly's PDF editor to enter your information in the provided fields. Ensure all details are accurate and legible. Save and download the completed form.

How do I apply for a Food Safety Certificate?

Complete the form with your personal and work information, gather necessary documents, and submit it to the Philadelphia Department of Public Health as per the instructions.

What documents do I need to submit for a Food Safety Certificate?

You need a copy of the course certificate, the completed application form, and a money order for the applicable fee.

How long does it take to receive the certificate?

The Office of Food Protection will mail the certificate within a maximum of 30 business days after receiving the completed application.

Can I pick up my certificate in person?

Yes, appointments are required to pick up completed certificates in person from the Office of Food Protection.

How do I get a replacement certificate?

Submit a completed application form for a replacement, a statement of the reason for replacement, and a money order for the applicable fee.

What do I do if my money order has a void date?

Ensure the money order does not have a void date of 45 or 90 days. Personal, business, or cashier's checks are not accepted.

Are there any businesses exempt from this requirement?

Yes, businesses selling only pre-packaged, non-hazardous foods are exempt from needing a Food Safety Certificate.

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Open the PDF in PrintFriendly's editor, input your information into the fields, adjust as needed, save your changes, and download the updated document.

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Philadelphia Food Safety Certificate Application

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