Complaint Form Template

January 18, 2010

in Complaint Forms

Each company should have a mechanism to record any complaint made by a customer or employee.  It is therefore important for you to have a complaint form.  This template can be used as an example to help you come up with a format that can be used to record complaints.

Name of Store or Company: _________________________________________________

Manager or Supervisor: ____________________________________________________

Name of Complainant: _____________________________________________________

Address: ________________________________________________________________

Telephone number: _______________________________________________________

Mobile number: __________________________________________________________

Email: __________________________________________________________________

Date of complaint: ________________________________________________________

Describe in detail and accurately the nature of your complaint: _____________________

________________________________________________________________________

________________________________________________________________________

Give the name of the person you first reported the complaint to: ____________________

________________________________________________________________________

________________________________________________________________________

Describe what actions can be taken in order to deal effectively with your complaint: ____

________________________________________________________________________________________________________________________________________________

Describe what measures can be taken to avoid a repeat of your complaint: ____________

________________________________________________________________________________________________________________________________________________

Signature of the Complainant: _______________________ Date: ___________________

Complainant recorded by: __________________________ Date: _

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