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:
Signature of person completing this form
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