Customer Complaint Form Template

Thank you for taking the time to complete our Customer Complaint Form. We apologize for any inconvenience caused and will do our best to investigate the matter and resolve the issue as soon as possible.
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*
1.
Full Name
*
2.
Email Address
*
3.
Phone Number
*
4.

Date of the Incident

*
5.
A Brief Description of the Incident
*
6.
Have you brought this incident to the attention of anyone at the company?
Yes
No
*
9.
How would you like the matter to be resolved?
Refund
Replacement
Repair
Compensation
An Apology
Other (Please Specify)
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