Making a Complaint

You can use this form to make a complaint about a service we have provided for you which you are not happy about. If you have not contacted us before about this matter, please use the Report a Problem form to tell us about it.

Your Complaint

You are complaining about:

Description of complaint
(please give as much information as possible such as What? When? Where? Who?)

What action do you want us to take to resolve it?
(e.g. What, When, Where, Who)

Contact Details

Please supply your details to receive a reply. If you do not wish to make a formal complaint please use the Report a Problem form.

First Name

Last Name

Address

Telephone

Confidential Monitoring

You do not have to fill in this part of the form. We are requesting this information to help us make sure we are providing a fair and equal service to everyone.

Are you? male female

Your age

Do you consider yourself to be a disabled person? yes no

Ethnicity

Asian
Bangladeshi
Black African
Black Caribbean
Black Other
Chinese
Indian
Mixed White Asian
Mixed White Black African
Mixed White Black Caribbean
Mixed White Other
Other
Pakistani
White British
White Irish
White Other

Office use only (please do not fill this box):