Complaints, Compliments and Feedback Form

Gives customers a channel to submit complaints, compliments, or suggestions, and lets the internal team log how each case was followed up.

Use this template

Instructions

Who reviewed this Submission

What date was this reviewed

What was the result of this Submission?

Is further action required

Yes No

Details of further Action required

Feedback Type

Complaint Compliment Suggestion

Date Reported or Discussed

Name

First Name

Last Name

Best Contact Method for Us to Respond

Where would you like to meet?

In Person Phone Call Video Call

Address

Street Address

City

State / Province

ZIP / Postal Code

Phone Number

Email

Please Provide Details

Was this discussed or reported to anyone? If so, who?

Are there any Outcomes you would like to see happen regarding this?

Please attach any further documentation (copies of emails, forms, written statements, etc.)

Max 10 MB per file

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