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Complaints form

Details of your complaint You should include as much information as possible in this section Name of the organization or person you are complaining about *
If relevant, give the organization or person’s contact details
Give a description of what happened: *
How did this affect you? *
How did you personally suffer because of this? *
When did you first become aware of the problem?
If more than 12 months have passed since you first became aware of the problem, explain why you did not complain sooner:
Have you complained to the organization or person in question?
If yes, when?
If relevant, what was the organization or person’s response to your complaint?
Title *
Name *
Surname *
Address *
Post code
E-mail
Telephone
How would you like to be contacted? (please ensure you have provided the relevant contact details) *
Are you completing this form on behalf of someone else? (If so, please enter their details in the boxes below) *
Person’s title:
Person’s name:
Person’s surname:
Address:
Postcode
Phone number
E-mail
What is your relationship to the person on whose behalf you are complaining?
Why are you complaining on this person’s behalf?
Please enter the characters shown above *Can’t read the text? Click “Reset” to try another. If you continue to have problems please call 0345 6033 221 and we can provide you with a code over the phone.
We have a privacy statement that tells you how we collect, use, disclose, transmit and store your personal data. It explains that the Commissioner may share your personal data (eg name, address, telephone number etc) if necessary to deal with your complaint. More information is available by following this link www.comisiynyddygymraeg.cymru/English/Pages/Privacy.aspx
 

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