Customer Complaint Form

CUSTOMER INFORMATION

Customer Name:

Customer Phone:

Customer Address:

Contact Name:

Contact Position:

Customer P.O. No.:

Invoice Number:

Product Number:

Product Description:

COMPLAINT INFORMATION

Complaint Date:

Complaint Taken By:

Complaint Details:

First Response Corrective Action:

Suspected Cause:

Corrective Action Person(s):

Corrective Action Follow-up:

What steps should be considered to avoid a repeat of the problem:

Date: