• Coventry & Warwickshire Mind > Complaint Form
  • Complaint Form

    Complaint Form

     

    In line with the requirements of the Disability Discrimination Act 2000, we can make reasonable adjustments to assist you if you have a disability that prevents you from making your complaint in writing. We can also help if English is not your first language. If you need any other assistance we would be more than happy to help.

     

    Name*

    Email Address*

    Telephone number/s*

    Address

    Postcode

    Your Complaint

    Please provide details of your complaint including names and contact details of any witnesses, date(s) of the alleged incident(s). If you cannot provide exact dates it is important to give an approximate time frame. If the allegation(s) being made occurred

    Outcome

    Please tell us what outcome you are looking for or hoping to achieve by submitting this complaint.