Complaint log
Please log complaints through this form and track progress until the case is resolved. Complaints are sent to
Log Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of Complaint
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name of Service user
*
Service User's Email
*
Service User's Phone Number
Staff Member Name
*
Staff Position
*
Staff Position
*
Nature of complaint (please describe):
*
Has contact been made?
*
Yes
No
Contact has been made. No Response.
Other
Action taken (please describe):
*
Agreed actions for resolution
*
Is the complaint resolved?
*
Yes
No
Other
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You have a duty to alert relevant staff when a log has been submitted.
Please contact: stnoffice12@gmail.com or suehalawa@yahoo.com.
Submit
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