Attachment_7_-_Complaint_Record.pdf

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Multidiscipline Healthcare Services
Solicitation number
HSCG23-17-R-P1C000
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Attachment 7 - Compliant Record

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Text version

HSCG23-17-R-P1C000 ATTACHMENT 7 Page 1 of 1

CUSTOMER COMPLAINT RECORD

DATE / TIME OF COMPLAINT: __________________________________________________

SOURCE OF COMPLAINT: _____________________________________________________

ORGANIZATION:_________________________ INDIVIDUAL: ________________________

NATURE OF COMPLAINT: _____________________________________________________

CONTRACT REFERENCE: _____________________________________________________

VALIDATION: _______________________________________________________________

DATE / TIME CONTRACTOR INFORMED OF COMPLAINT: __________________________

ACTION TAKEN TO CORRECT: _________________________________________________

ACTION TAKEN BY CONTRACTOR: _____________________________________________

RECEIVED/VALIDATED BY: ____________________________________________________

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