Sample Forms

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Customer Complaint Form

A customer complaint form is a document that records any complaint made by a customer that occurred within the store.  No matter thecomplaint, this form enables the incident to be recorded and thus can be used as evidence in case of a lawsuit.  The format is simple but quite effective.

Name of the store: ________________________________________________________

Address of the store: ______________________________________________________

Store Manager’s name: ____________________________________________________

Date: ___________________________________________________________________

Name of customer: ________________________________________________________

Address: ________________________________________________________________

Mobile number: __________________________________________________________

Home number: ___________________________________________________________

Email address: ___________________________________________________________

Date of complaint: ________________________________________________________

Describe in detail the complaint: _____________________________________________

________________________________________________________________________

________________________________________________________________________

Describe who you reported the incident to and how they dealt with it: _______________

________________________________________________________________________

________________________________________________________________________

Describe how the store can deal effectively with your complaint: ___________________

________________________________________________________________________

________________________________________________________________________

What recommendations would you make in order to avoid any reoccurrence of such an incident? ________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Manager’s comments: _____________________________________________________

________________________________________________________________________

________________________________________________________________________

Customer’s signature: ___________________________ Date: ___________________

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