Gluten-Free Establishment Notification Form

Name (facultative filling)

E-mail (facultative filling)

Are you using this form to notify a new address or modify an existing one ?(mandatory)

New address (address that currently does not appear on the map)

Address mdoficiation (address that appears on the map whose information changed since last update)

Please indicate the name of the establishment

Please indicate the country of the establishment

A) If it is for an address modification, please fill the fields below. Otherwise, you can directly go to section B)

What is/are the information that need(s) to be modified ?

The address The gluten-free option (100% GF or GF friendly) Coeliac recommandation The availibility of dairy-free option The availibility of vegan option The opening hours / days Open for business field (open or closed permanently)

Please indicate the updated value (if several fields need to be updated, please indicate before which field you are referring to)

B) The filling of all the fields below is not mandatory. Fill it only if you have the information. The fields below are only applicable to new entries. If you submit this form to notify a modification, you can directly go to section C).

Please indicate the full address of the establishment ou share the link to Google maps to locate it.

Which kind of establishment is it ?

A restaurant

A bakery and/or cake shop

A grocery

Is the establishment located at several addresses (is it a chain) ?

Yes

Is it an establishment 100% GF or GF friendly ?

Yes

Do you recommend this establishment to coeliac ?

Yes

Are dairy-free options available ?

Yes

Are vegan options available ?

Oui

C- Please indicate below, any comment you would like to share with us. It can be about the new address but also any other remarks about the website. The filling of this field is not mandatory.

Gluten-Free Establishment Notification Form

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