Formal School Complaint form
Your Name
*
First Name
Last Name
Have you read our Complaints Policy and Procedure (available on our website Broom Barns Primary School » Statutory Information )
*
Yes
No
Name of pupil
*
First Name
Last Name
Your relationship to the pupil
*
Your Address
*
Street Address
Street Address Line 2
Town
Postcode
Phone Number
*
Please enter a valid phone number.
Format: 00000000000.
What is the nature of your complaint? Please give details
*
What action, if any, have you already taken to try and resolve your complaint. (Who did you speak to and what was the response)?
*
What are your desired outcomes? What actions do you feel would resolve the problem at this stage?
*
Have you raised your concerns at the informal stage? If so, when did you do this?
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Yes
No
Date you raised your concerns
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
If yes - have you received an informal response to your concerns yet?
*
Yes
No
Date you received an informal response to your concerns
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Have you submitted a formal complaint at Stage1?
*
Yes
No
Date you submitted a formal complaint at Stage1
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Are you attaching any paperwork below? If so, please give details.
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Signature
*
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
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