Complaint form
If you have not already done so, please read our leaflet ‘How to complain to Dartford
Borough Council’.
We encourage you to raise your complaint directly and informally with the staff
member you have been dealing with.
If you have not been dealing with anyone or do not know who to contact about your
complaint, or if you need advice or help in filling out this form, contact our Customer
Services, Civic Centre, Home Gardens, Dartford, Kent DA1 1DR.
Telephone: 01322 343434 and we welcome calls by NGT Relay
Email: complaints.officer@dartford.gov.uk
Once you have completed this form please save it and email it to:
complaints.officer@dartford.gov.uk
or alternatively please print it and send it (with the monitoring form) to:
Corporate Complaints Officer, Dartford Borough Council, Civic Centre, Home Gardens,
Dartford, Kent DA1 1DR
Privacy policy – your personal information
Dartford Borough Council supports the objectives of the Data Protection Act 1998 and
is registered as a data processor. If you use our complaints procedure, you are agreeing
that we can use any personal information you send us for purposes connected with
your complaint.We may also give your personal information to other people and
organisations if we have to do so by law or if you have given us permission.
Please fill in this form online, save it and then email it to:
complaints.officer@dartford.gov.uk
Please complete this form as clearly and
accurately as you can
1. Mr
Ms
Mrs
Miss
Other (please insert).........................................................................................
2.
Address:
..............................................................................................................................................................................................................................................
..............................................................................................................................................................................................................................................
..............................................................................................................................................................................................................................................
Postcode:
Email:
3. Daytime contact phone number:
Note: Please put in the telephone number where we can contact you between 9am and 5pm.Tell us if it is your
home or work, or the number of a neighbour or friend. If you do not have a daytime contact number, please
put down a number with an answerphone where we can leave a message during the day. If you do not have
any of these, please leave this section blank.
4.
Your special requirements:
If anything makes it difficult for you to use our service, for example if English is not your first language or you
have a disability, please use the space above to tell us how we might help you.
5. Is your complaint about a particular person or department?
6.
What is the nature of your complaint?
First name:
Surname:
Name of person:
Name of department:
2
Please complete this form as clearly and
accurately as you can
7. How has this affected you?
8.
What do you think the Council should do to put things right?
It will help us to deal quickly with your complaint if you send us copies of any letters or documents about it.
Your signature: Date:
To be signed by the person making the complaint or by the person representing the complainant.
Note: You can ask someone to help you with your complaint: this can be the Citizen’s Advice Bureau or other
organisations (see the leaflet ‘How to complain to Dartford Borough Council’), or your local Councillor, or a
friend or relative as long as they have your permission to represent you. We will help you to complete the form if
you ask us.
This section is for Dartford Borough Council use only
If completed by Customer Services, or another Council Officer, nature of the complaint must be confirmed with the
complainant and a copy of this form sent/given to the complainant.
Nature of complaint confirmed with the complainant? Yes
No
Date:
Copy of this complaint form to the complainant? Yes
No
Date:
3
Monitoring our Comprehensive Equality Policy
We want to find out if we are giving as good a service as we can to all complainants.
To help us do this, please fill in this form and send it to us. If more than one person has
made the complaint, it would be helpful if only one fills in the form.The information we
get from all replies will help us review and decide how we can assist as many people as
possible.This information will not be sent to the service department you are complaining
about and will not affect the way your complaint is handled.
Note: Ethnic groups are not about nationality, place of birth or citizenship.They are about colour and cultural
background.
1.
Ethnic Group
White:
British
Any other white background
Mixed
White and Black Caribbean
White and Asian
Asian or Asian British
Indian
Bangladeshi
Black or Black British
Caribbean
Any other black background
Chinese
Irish
White and Black African
Any other mixed background
Pakistani
Any other Asian background
African
Other ethnic group
2.
Sex
Male
Female
Age
Under 16
16
-19
20 -24
25-59
60-64
65 and above
3.
(continued overleaf)
4
Monitoring our Comprehensive Equality Policy
4.
If you have a disability, what is its nature?
Difficulty getting around
Hearing difficulty
Difficulty seeing
Learning difficulty
Mental health problems
Other
5
Notes to help you fill in the complaint form
If you or anybody you know requires this or any other Council information
in another language, please contact us and we will provide this for you.
Braille, audio tape and large print versions of this document are available
upon request.
Tel: 01322 343434
Fax: 01322 343422
Email: customer.services@dartford.gov.uk
Calls are welcome via NGT Relay
The Corporate Complaints Officer, Civic Centre, Home Gardens, Dartford Kent DA1 1DR
Tel: 01322 343434 Fax: 01322 343422
E-mail: complaints.officer@dartford.gov.uk Website: www.dartford.gov.uk
NC/CA08/2015
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