Complaints Form

Age Concern West Sussex Complaints Form We want to know if you are not happy with the service you have received from us. For example, if you….. • • •

Are unhappy with the way your enquiry was handled Feel that you have not been treated respectfully Have concerns about any aspect of the service we provide, such as our policies, procedures or activities

……please fill in the following and return the form to us. We will try to resolve your complaint by discussing it with you in the first instance. If this is not possible, or you are not happy with the outcome, you can make a formal complaint. Within 5 days of receipt, you will be told who is looking into the complaint, what action is being taken and when a reply can be expected.

Please complete the following information, then give details of your complaint overleaf.

The purpose of our Complaints Procedure is to: •

Your name: ………………………………………… …………………………..

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Your address: ………………………………………… ………………………………………… ………………………………………… ………………………………………… ………………………………………… …...

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Your telephone no: ………………………………………… ……………………………. Your email address (if applicable): ………………………………………… ………………………………... Is it OK to contact you using the above details? Yes/No

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protect the interests of individual service users; improve the quality of our services by being responsive to the views of people affected by its services; enable service users, potential users and carers to comment upon or challenge decisions and information / advice given by us; provide an additional means of monitoring the performance of this organisation; maintain a customer care philosophy within this organisation West Sussex

Suite 2, 1st Floor, Anchor Springs, Littlehampton, West Sussex BN17 6BP (01903) 731800 [email protected]

Please tell us the details of your complaint:

Please tell us what you feel should not have happened:

Please tell us what you would like us to do now:

Thankyou for completing this form. We will contact you about your complaint within 5 working days.

Please return to: Age Concern West Sussex Suite 2, 1st Floor, Anchor Springs Littlehampton, West Sussex BN17 6BP