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Are you complaining on behalf of someone else?
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Your details
Are you complaining on behalf of a business, charity or trust?
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Are you complaining on behalf of a business, charity or trust?
Yes
Are you complaining on behalf of a business, charity or trust?
No
What is your job title?
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What is your relationship to the complainant (the person on whose behalf you are complaining)?
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Title
Mr.
Mrs.
Cllr.
Dr.
Miss.
Ms.
Mx.
Sir.
MP
First name
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Last name
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Postcode
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Address
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Telephone number (Landline or Mobile. For example: 02082744901)
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Email address
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How would you like us to contact you?
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How would you like us to contact you?
Email
How would you like us to contact you?
Phone
How would you like us to contact you?
Post
There will be times when we need to send you documents. How would you like to receive them?
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There will be times when we need to send you documents. How would you like to receive them?
Post
There will be times when we need to send you documents. How would you like to receive them?
Email
Special contact requirements (e.g. Large print, la
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Title
Mr.
Mrs.
Cllr.
Dr.
Miss.
Ms.
Mx.
Sir.
MP
First name
*
*
Last name
*
*
Postcode
*
*
Address
*
*
Telephone number (Landline or Mobile. For example: 02082744901)
*
*
Email address
*
*
How would you like us to contact you?
How would you like us to contact you?
Email
How would you like us to contact you?
Phone
How would you like us to contact you?
Post
There will be times when we need to send you documents. How would you like to receive them?
*
There will be times when we need to send you documents. How would you like to receive them?
Post
There will be times when we need to send you documents. How would you like to receive them?
Email
Complaint
Which service are you complaining about?
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Have you reported this issue before?
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Have you reported this issue before?
Yes
Have you reported this issue before?
No
Issue reference number
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Issue reported date
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What do you think the council has done wrong?
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How has this affected you?
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What do you think the council should do to put things right?
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Citizen/ Resident
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