Complaint form template
Structured complaint intake: what happened, when, who was involved, what resolution they want and contact details.
6 questions · about 4 minutes to complete · free on every plan
Free account required. The template is copied into your workspace; edit anything before publishing.
- When to use it
- On your website's complaints page.
- Who it is for
- Customers or members with a complaint.
How to use this template
- Keep it to four fields.
- Set an expectation for reply time.
- Route complaints to a person, not a shared inbox.
Questions in the complaint form template
1. Your details
contact info
2. When did it happen?
date
3. What does it relate to?
dropdown · A product, A service, A member of staff, Billing, Something else
4. Describe what happened
open text
5. What outcome would resolve this for you?
open text
6. Have you raised this with us before?
single choice · Yes, No
What the results look like
IllustrativeSynthetic sample of 120 responses generated for this preview, not real survey data. Your results page shows the same charts for your own responses.
1.What does it relate to?
120 answered| Answer | Count | Percent |
|---|---|---|
| A product | 24 | 20% |
| A service | 30 | 25% |
| A member of staff | 8 | 7% |
| Billing | 44 | 37% |
| Something else | 14 | 12% |
2.Have you raised this with us before?
120 answered| Answer | Count | Percent |
|---|---|---|
| Yes | 47 | 39% |
| No | 73 | 61% |
How to read these questions
- dropdown: Treat like a single choice; group long lists into a few buckets before comparing segments.
- single choice: Read the share choosing each option, then cross-tab by a segment question to see who differs.
Frequently asked questions
What fields should a contact form have?
Name, email, topic (dropdown) and message. Phone is optional. Everything else reduces submissions.
How long does the complaint form take to complete?
About 4 minutes: 6 questions, most of them single-tap. Every question can be edited, removed or reordered in the builder before you publish.
Is this template free to use?
Yes. Every template is included on the Free plan. Sign up, click Use this template, and it is copied into your workspace where you can edit it, add your logo and share it by link, email or embed.
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