COMPLAINTS - internal

This form is for use by staff, Board members, volunteers or students on placement to give feedback about the conduct of staff, Board members or volunteers. It is not for reporting accidents or incidents. Incident Report form : https://app.smartsheet.com/b/form?EQBCT=6865a9b7102c4bf1b8e09cfc3539a933 __________________________________________________

FOR EXTERNAL COMPLAINTS OR FEEDBACK: Use the 'FEEDBACK - external' form: - to summarise a phone call you took, - to copy & paste text from an email - to copy from a letter or other source to upload the details of a complaint or other feedback from a client, client's family, an external professional or member of the public. This allows our automated notification system to drive follow up to that complaint. Link to the 'Feedback - external form': https://app.smartsheet.com/b/form?EQBCT=cb7fd62843474e69b019c061b80daedc

Date of this report*

My name

This complaint is about

Name of person my complaint is about

I want this complaint to be treated:

formally

informally

not sure

What happened that you'd like to complain about?

Event date

Event time

If you're not sure, please give your best guess

Where did it happen?

Who was there?

What happened?

What people did and said, what you thought, how you felt etc

Have you discussed this with anyone else at EveryMan, or outside of EveryMan?

Yes

If yes, please give details

If you don't wish to identify the person you spoke to, it's ok to leave this section blank

Specific complaints about what happened

e.g.

the way the person spoke to me was intimidating
no-one asked what I thought or felt
the person I spoke to about it didn't seem to take my concerns seriously

Contacting you

We'll use your private email and mobile phone to contact you and keep you updated with the progress of response to your complaint. If you'd rather not be informed, please let us know.

What would you like to see happen?

Following up your complaint

Would you like us to keep you posted about what we're doing with your complaint?

Yes

Not sure

If you said no

please let us know why.

If you want to be kept informed, who would you prefer to contact you?

Your private email address

Your private mobile

File Attachments

If you have a document or image on your computer which is related to this feedback, please upload it here.

Drag and drop files here or

Is there anything else you want to say?

Send me a copy of my responses

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