Employee Complaint
Tell us what happened in the form below.
Company Name
*
Name of Employee
*
Date of Complaint
*
-
Month
-
Day
Year
Date
Supervisor’s name
*
Describe accurately the details of your complaint and against whom:
*
Describe how the incident you are complaining about has impacted negatively on your work:
*
Describe how the company can deal effectively with your complaint:
*
Give additional comments which you believe will be important during further investigations of your complaint:
*
By signing you declare that all information you have given here is truthful and accurate.
Signature
Employee Signature
Submit Complaint
Should be Empty: