Employee Complaint Form
Employee Complaint Form
Please complete the following form to submit a complaint.
Employee Information
Name
Date of Complaint
Supervisor
Complaint Details
Date of Incident
Location of Incident
Type of Complaint
Person(s) Involved
Complaint Details
Provide a detailed account of the incident.
Impact on Job Performance
Explain how this incident has negatively affected your job performance.
Have you previously reported this incident to a supervisor or manager?
Proposed Resolution
Suggest actions or solutions the company can take to resolve your concern effectively.
Additional Information
Include any further details or insights that may be helpful during the investigation of your complaint.
Acknowledgement
By signing below, I acknowledge that the information provided in this complaint form is accurate and truthful to the best of my knowledge.
Name:
Date:
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Thank you for submitting your complaint.
We will investigate this matter promptly.
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