COMPLAINT RECORD FORM

Details of person making the complaint

Note: This form can be completed electronically or by hand.

Date complaint received:
Does the person making the complaint wish to remain anonymous?
YesNo
Category of person making complaint:
Preferred method of contact:

(if participant is not the person making the complaint)

Participant details

Is the participant an existing client?
YesNo

(if complainant is not the participant)

Complaint details

Current status of complaint: