Complaints and feedback form

Title *

Please select Mr Mrs Miss Ms Dr Other

First Name *

Surname *

Address 1 *

Address 2

Town *

Postcode *

Contact Telephone Number *

Email

Why are you contacting us? *

Please select Getting involved Training General enquiry Complaint Feedback

Additional Comments

Select a category *

Please select Pest control Pets Parking Keys/key fobs Mutual exchange Housing transfers Housing waiting list Right to buy Right to acquire Staircasing Changes to tenancy Other

Please provide as many details as you can *

When did this problem first start occurring? *

When did this problem first start occurring? shadow

Please provide us details about your complaint *

How have these problems affected you or your family? *

How would you like us to resolve your complaint? *

Are there any vulnerable family members in your household? (tick all that apply)

No vulnerability

Elderly resident over 70

Elderly resident over 80

Young children under 3 months

Young children under 12 months

Serious medical condition

Mental health disability

Physical disability

What is your desired outcome? *

Please select Apology Provide a service Policy change Compensation

Which opportunity are you interested in?

Please select Community Champions Focus Groups Local Panels Mystery Shopping Resident Associations Resident Groups Readers Group Resident Quality Inspectors (RQIs) Scrutiny Panel Surveys Young Ambassadors

Do you have any suggestions for other opportunities that you would like to see?

Would you like us to contact you about this?

Yes

No

How can we help you?

Getting into work

Training

Support and advice

Book onto a workshop/course

Which workshop/course would you like to book onto? *

Do you want us to contact you?

Yes

No

Need to send a picture of your repair or other image? Upload it here Please do not include any photos of people