An employee complaint form is a very important document as it can be used in a court of law as evidence when facing a lawsuit. It enables thecomplaint to be recorded accurately and truthfully. This template can be used as an example about the general format of such forms.
Name of the company: _____________________________________________________
Name of employee: _______________________________________________________
Job title: ______________________________________________________
Date of complaint: ________________________________________________________
Describe in detail the nature of your complaint including names of all individuals involved, witnesses of the incident and any proof you might have about the complaint: __
________________________________________________________________________
________________________________________________________________________
Give details about how the incident has affected your ability to work effectively: ______
________________________________________________________________________
________________________________________________________________________
What actions could the company take in order to effectively deal with your complaint? __
________________________________________________________________________
________________________________________________________________________
Give any additional comments that would be helpful in dealing with your complaint: ___
________________________________________________________________________
________________________________________________________________________
Employee signature: _________________________ Date: _______________
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