Free Facility Complaint Form Template
Facility Complaint Form
Please complete all sections to help us address your complaint promptly.
Personal Information
Name
Address
Phone Number
Facility Membership/ID Number (if applicable)
Complaint Details
Date of Incident
Facility Name or Location
Staff Member(s) Involved (if known)
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Contact Number |
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Nature of Complaint
Check all that apply:
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Maintenance Issue (e.g., broken equipment, cleaning)
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Safety or Hazard Concern
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Accessibility Issue
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Unprofessional Staff Behavior
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Noise or Disruption Complaint
Description of Incident
Provide a detailed account of the issue, including dates, times, and relevant interactions. Attach additional pages if necessary.
Action Taken
Have you reported this issue to anyone else?
If yes, please specify:
Desired Resolution
Describe how you would like this to be resolved.
Supporting Document
Upload a file to support the complaint.
By signing below, I affirm that the information provided is accurate to the best of my knowledge.
Name:
Signed:
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