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Complaint Form  
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name:
address:
e-mail:
home telephone number:
work telephone number:
may we ring you at work?:
ethnic origin - this question is purely for statistical purposes
what is your complaint?:
other (please specify)
have you already taken steps to complain to a member of staff?:
what was the name of the person you contacted?:
did they meet with you?:
did they telephone you?:
did they write you a letter?:
other (give brief details)
please describe your complaint in your own words (use extra sheets of paper if necessary). Be as clear as you can:
how would you most like your complaint to be resolved?:
 
  
 
 

 

  
 
 
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Helping you speak to the right member of Adactus please see contacts page.

  
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