Client Complaint Form
We are committed to providing a high-quality service. If you are unhappy with any aspect of our service, please complete this form. Your complaint will be handled in accordance with our Complaints Policy and Procedures. You will receive an acknowledgement within five working days if the matter cannotbe resolved immediately, and a written response will normally be providedwithin fourteen working days.
Date
*
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Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number. e.g. (021) 234-5678
Format: (000) 000-0000.
Email
example@example.com
Your preferred method of contact
*
Phone
Email
Letter
Date incident occured (if known)
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Month
-
Day
Year
Date
Details of your complaint. Please tell us what happened, including the date(s), time(s), location(s), and the name(s) of any staff member(s) involved (if known).
*
What outcome would you like?
Supporting information. Please upload any documents or information you have.
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