ContactQuestions? Comments? We’d love to hear from you!Please complete the form below. Mandatory fields marked*"*" indicates required fieldsWhat type of feedback do you want to share?*Select OneProduct FeedbackGeneral InquiryPlease select the specific reason for your feedback:*Select OneProduct TextureProduct Taste / FlavourProduct ComplimentProduct BreakageOther Product Inquiry / IssueInjuryIllness/AllergyForeign Material in ProductPlease select the specific reason for your feedback:*Select OneIngredient InquiryAllergen InquiryBest Before Date InquiryCoupon RequestDonation/Sponsorship RequestStore Locator InquiryOther RequestInjury DetailsPlease describe the injury you experienced (please share as much information as possible).*When did the injury occur?* Did you seek out medical treatment?* Yes NoWhat 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 NoWe 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 DetailPlease 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 NoWhat 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 NoWe 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 DetailPlease describe the foreign material.*Was any injury sustained from the foreign material?* Yes NoDid you seek out medical treatment?* Yes NoWhat 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 NoWe 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 InformationBrand:*Select OneCroccantini® Artisan CrackersBruschettaProduct:*Select OneOriginal Sea Salt Croccantini® (6 oz)Original Sea Salt Croccantini® (3 oz)Original Sea Salt Croccantini® (8 oz)Rosemary Croccantini® (6 oz)Rosemary Croccantini® (3 oz)Rosemary Croccantini® (8 oz)Cracked Pepper Croccantini® (6 oz)Roasted Garlic Croccantini® (6 oz)Roasted Garlic Croccantini® (3 oz)Toasted Sesame Croccantini® (6 oz)Whole Wheat Croccantini® (6 oz)Multigrain Croccantini® (6 oz)Product:*Select OneOlive Oil & Sea Salt (4.23 oz)Tomato & Basil (4.23 oz)Garlic & Parmesan (4.23 oz)Purchase DetailsHave you purchased this product before?* Yes NoPurchase LocationBest Before Date*Example: 170422KB1 (YYMMDD Plant Shift)Contact DetailsFirst Name*Last Name*AddressCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip CodeCountryUnited StatesEmail* PhoneHow May We Contact You?*Select OneEmailPhoneMailNo Contact NecessaryCommentsPlease enter your comments and feedback below:*AttachmentsPlease attach any relevant files Drop files here or Select filesAccepted file types: jpg, gif, png, pdf, Max. file size: 2 MB.Maximum 2MBMailing ListWould you like to receive updates on promotions, new product launches, recipe ideas, and special offers, or to participate in a survey from La Panzanella® Artisanal Foods Co.?* Yes NoDo you provide permission for La Panzanella® Artisanal Foods Co. to use comments in this form for internal or external marketing purposes, including advertising and social media?* Yes NoCAPTCHA
