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1 Complaint Handling Form
COMPLAINANT DETAILS: | |||||||
NAME: | ADDRESS: |
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TEL/MOB: | EMAIL: | ||||||
ACCOUNT NO: | REF: | ||||||
COMPLAINT DETAILS: | |||||||
DATE/TIME COMPLAINT RECEIVED: | |||||||
COMPLAINT RECEIVED BY: | |||||||
DATE/TIME OF INCIDENT: | |||||||
NATURE OF COMPLAINT:
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SYSTEM/EMPLOYEE/PROCESS INVOLVED IN COMPLAINT:
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INVESTIGATION DETAILS:
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ROOT CAUSE ANALYSIS:
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MEASURES TO PREVENT REPEAT OCCURRENCES:
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OUTCOME:
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OFFICE USE ONLY: | |||||||
Notes
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RECEIVED BY: | DATE RECEIVED: | ||||||
RECORDED ON COMPLAINT LOG: | YES/NO | REPORTED TO SUPERVISORY AUTHORITY? | YES/NO | ||||
INVESTIGATED BY: |