Feedback/Suggestions/Complaints Form Feedback/Suggestion/Complaint Form ServiceFigtree ELCDSAdministrationDate Feedback Received Staff member receiving feedback/suggestion/complaint First Last Name of person making the suggestion/complaint First Last Address Street Address City State / Province / Region ZIP / Postal Code PhoneRelationship to service userFeedback/ Suggestion/ Complaint (brief description)Staff member handling matter First Last Negotiated solutions/options1.2.3.Agreed solution chosenAction PlanActionStaffTime FrameDate Completed ActionStaffTime FrameDate Completed ActionStaffTime FrameDate Completed SignatureDate CEO Notified Yes No Background/Additional CommentsOutcome/Resolution/Follow up
