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  • Complaint Form Sample

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    omshanker44
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    This complaint form from Imexco International in Noida collects information about a customer complaint including the customer and supplier names, date and time of complaint, method of complaint, a description of the complaint, whether an incident form was completed, notifications made to the practice manager, an acknowledgement letter sent, the action taken on the complaint, if it was resolved satisfactorily, and if an outcome letter was sent.

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    Complaint forma sample

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    This complaint form from Imexco International in Noida collects information about a customer complaint including the customer and supplier names, date and time of complaint, method of complaint, a description of the complaint, whether an incident form was completed, notifications made to the practice manager, an acknowledgement letter sent, the action taken on the complaint, if it was resolved satisfactorily, and if an outcome letter was sent.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    151 views1 page

    Complaint Form Sample

    Uploaded by

    omshanker44
    This complaint form from Imexco International in Noida collects information about a customer complaint including the customer and supplier names, date and time of complaint, method of complaint, a description of the complaint, whether an incident form was completed, notifications made to the practice manager, an acknowledgement letter sent, the action taken on the complaint, if it was resolved satisfactorily, and if an outcome letter was sent.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 1

    Practice Name or Logo

    Imexco International, Noida


    Complaint Form
    Customer Name: ________________________________________________________
    Supplier Name: _________________________________________________________
    Details of receipt of complaint
    Date of complaint: _______________________________

    Time: __________________

    Reply given: _________________________________________________________


    Complain ref. (order no. + Serial no.):______________________________________
    Method by which complaint made:

    Phone

    in person

    Letter

    Email

    Details of complaint
    Description of event/complaint
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________
    Was an Incident form completed? Yes

    No Date: ____________

    Time: ___________

    Practice Manager notified:

    Date: ____________

    Time: ___________

    Complaint acknowledgement letter sent:

    Date: ____________

    Time: ___________

    Outcome
    What action was taken?
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________
    ________________________________
    Was placed in agenda for the next Practice meeting:

    Yes

    No

    Was this matter satisfactorily resolved?

    Yes

    No

    Was letter of outcome sent to person making complaint?

    Yes

    No

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