Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Source Of Complaint

  •  Customer  Consumer  Regulatory agency - Please specify

  • Name and address of Branch involved

Complainant Details:

  • Customer Name

  • Complainant address:

  • Complainant Contact Number:

  • Complainant Email address:

  • Sex (Female/Male)

  • Food Consumed

  • Date and Time Consumed

Type of Complaint

  •  Product quality  Illness  Allergen  Foreign body - Please specify

Product Details

  • Product Name

  • Batch Code:

  • Production Date:

  • Best Before/Used By Date:

  • Delivery Date

  • Quantity Purchased

Complaint details

  • Brief details:

  • Photo evidence

  • Have they suffer any injury?

  • Do they have any medical evidence?

  • Do they haven receipt of any expenses incurred?

  • Have they reported the complaint to any third party e.g. Individual or government organisation?

Root Cause

  • Brief Details:

Response to complainant

  • Brief Details

  • Is product Withdrawal /Recall required?

  • Corrective action required?

Action to be taken

  • Brief details of action

Complaint closed off

  • Completed by

  • Date completed

  • Signed

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.