Client_Complaints_Form_for

1

Full Name:

2

Email Address:

example@example.com

3

Phone Number (optional):

4

Preferred Contact Method:

Email

Phone

No contact required

5

Practitioner's Name:

6

Business Name (if applicable):

7

Location of Appointment:

8

Date of Appointment or Incident:* This field is required.

Date

9

Please select all that apply:

10

Nature of Your Concern Options

Professional conduct

Boundaries or ethics

Safety or safeguarding concern

Cultural misrepresentation of Thai massage

Quality of treatment

Communication or customer service

11

Fees, cancellations, or business practices

Other

12

Please describe the issue in as much detail as you feel comfortable sharing. Include dates, what occurred, and who was involved. Your Description:

13

14

You may upload or reference any relevant information, such as:

Emails or messages
Screenshots
Appointment records
Photos
Witness statements

List any attachments or evidence:

15

16

Yes

No

17

If yes, please describe what happened and any response you received:

18

19

Please tell us what you hope will happen next. Examples: an explanation, an apology, investigation, safeguarding action, or no further contact.

20

21

Privacy and consent notice* This field is required.The personal information you provide will be used by UKTMRC to review and respond to your complaint, and to help protect the public. We will handle your information in accordance with the UK GDPR and the Data Protection Act 2018. Your information may be shared where necessary for complaint handling, legal compliance, or public protection.

I understandthaf UKTMRC will process the information I provided in this form for the purpose of handling my complaint and protecting the public

22

* This field is required.

I consent to UKTMRC contacting me about this report.

I wish to remain anonymous (optional).

23

* This field is required.

I confirm that the information I have provided is accurate to the best of my knowledge. I understand that false or misleading information may affect how my complaint is handled

24

Signature (typed name):* This field is required.

25

Date:* This field is required.

Date