Housing Complaints Form
Complainant Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Received By
*
First Name
Last Name
Department
*
Nature of complaint
*
Category (choose all that apply)
*
Accommodation Management
Support Services
Maintenance Issues
Health and Safety
Letting and Allocations
Personal Issues and Wellbeing
Other
Action Taken
*
Resolved (choose TBC if not resolved at initial stage)
Staff
Team Leader
Manager
CEO and Board
Ombudsman
TBC
Signed by Complainant
*
Signed by Staff Member
*
Position of Staff Member
*
The following complaint review is for internal use only
Stage at which complaint resolved (please type TBC if not resolved before submission of this form)
*
Staff feedback required?
*
Yes
No
TBC (to be used if not decided before submission of form)
If yes give details of who, how and when (type TBC if not decided before submission of form or type No feedback required)
*
Review of procedure required?
*
Yes
No
TBC
If yes to above please provide details or type N/A
*
Did complainant complete satisfaction questionnaire?
*
Yes
No
TBC
Analysis of feedback (please type TBC if not received prior to submission of form)
*
Collated for Board meeting (date) - please type TBC if not known prior to submission
*
Submit
Should be Empty: