Tickit on Demand - Horizon Foundation Inc

.T08.Compliment/Complaint/Comments (CCC)

This form is used to record any compliments or complaints about our services or event that involves an employee, service user or member of the public.

Date Occurred^*

Time Occurred

Division

I wish to lodge the following^*

ComplimentComplaintComment

Your Name

Your Email

Your Phone Number

I am A^*

If Other, please specify

Describe your compliment / complaint / comment^*

What would you like done about this?

Can we contact you?^*

YesNoNot Applicable

If you had assistance filling in this form, please provide contact details of the person assisting

(Name & phone number)