Customer Feedback Form

Personal Details

Items marked must be completed

Use Of The Form

	Customer Feedback about Adur District Council We value your feedback on our services, letting us know about your customer experience is important to us. We also like to know when we have got it right and welcome suggestions for improvement. Please use this form to submit any comments, complaints or compliments you may wish to make about Adur District Council.

	Form Ref. No.

	This form can be completed on-line When completed it should be either submitted electronically or printed and sent back to the Council.

Personal Details

	Title
	Forenames
	Surname


	Address Line 1
	Address Line 2
	Address Line 3
	City / Town
	County
	Postcode
	Phone - Home
	Phone - Work
	Phone - Mobile

	Email
	If we need to ask for more information, is it ok for us to do so by email?

	What is your prefered method of contact?

	Thank you for providing us with this feed back. From time to time Adur District Council may wish to contact you to hear your views on the way your comment, complaint or compliment was handled. This will help us to continually improve the services we provide.
	Please tick the box if you are happy for us to contact you for this purpose