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Complaint form
Full Name of Complainant *
Email address
Message *
Contact Name (if different from above)
Address of Complainant *
Contact Telephone No.
Contact for Mobile or Text
Contact for Email
What is your preferred means of contact? (tick all that apply) *
By Email
By Letter
By Telephone
By Text
Organisation, person or persons against whom the complaint is made
COMPLAINT:
Is the complaint about a specific Association policy, procedure or implementation of such? If so, please detail.
Nature of complaint, eg. verbal abuse/bullying, discrimination, personal property
Details, including date, time and place, witnesses, etc
PROPOSED SOLUTION:
(Optional)
Signature and Date: *
Relationship to Complainant if appropriate
ASSOCIATION NOTES:
Received: By/to whom / How / Date
Acknowledged: By/to whom / How / Date
Simple response (if appropriate): By/ to whom / How / Date
Investigation: By/ to whom / How / Date
Response given to Complainant: By/ to whom / How / Date
Accepted by Complainant; Complaint closed OR Rejected by Complainant: further investigation & response required: By / to whom / How / Date
Additional information; further steps; referral etc. (notes on seperate page if necessary)
Accepted by Complainant: Complaint Closed.
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