Client Complaint Form

24 Hotline Complaint Form

The 24-hour hotline complaint form is not used to report events presenting an immediate threat to life or property, if emergency assistance is required, please get in touch with your local authorities.

Protecting Your Privacy:

You have the option to submit this form anonymously by leaving the contact information blank. However, if you do include any contact information it will remain confidential and will only be viewed by Internal Audit.

    Customer Information

    Customer Name:

    Customer Phone:

    Email:

    Complaint Information

    Complaint Date:

    Complaint Details:

    First Response Corrective Action:

    Suspected Cause:

    Corrective Action person(s):

    Corrective Action Follow-up:

    What steps should be considered to avoid a repeat of the problem:

    Date: