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Service Complaint Form


Complaints, comments and compliments
If you wish to make a comment, compliment or complaint about the our taxi service, please fill in the boxes below and then press the submit button.
Boxes marked with an asterisk (*) must be filled in.
Please note that the information you provide here will only be used to process your comment or complaint and not for any other purpose.
This information will not be given or sold to any third parties. If you prefer not to use this form, you can fill-in and send the Word Doc with your comment or complaint by email to: call-a-cab@746746.co.uk

Your Full Name(*)
Please type your full name.

Full Address and Post Code(*)
Please enter your full address and postcode?

Your phone no (daytime)?
Please enter your Daytime Phone Number?

Please enter your Evening Phone Number?
Please enter your Evening Phone Number?

Your email address (Up to 35 characters) (*)
Invalid email address.

Are you making a complaint, comment or compliment(*)

Please enter complaint, comment or compliment?

What do you want to say or why do you want to complain?(*)
Please say or why do you want to complain?

What would you like the Call-a-Cab Ltd to do to improve things for me?
What would you like the council to do to improve things for me?

By completing the next section of this form you are helping us to ensure everyone in our community is treated equally. Treating people fairly Call-a-Cab Ltd values and celebrates the diversity of its people living, working and visiting in Brighton & Hove. We want to give a good service to all our customers. To help us do this, please fill in this section. This information will not affect the way your complaint is dealt with and you do not need to fill this in if you do not want to. we will deal with you complaint in any case and will be in contact soon.

Sex

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Age
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Ethnicity To which of these ethnic groups do you consider you belong? Please pick one from the sections a-f and mark one box. The categories in this section are the same as those used in the 2001 UK Population Census.


a) White

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Other White background
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b) Black or Black British

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Other Black background
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c) Asian or Asian British

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Other Asian background
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d) Mixed

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Other Mixed background
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e) Chinese
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f) Other ethnic background
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Disability

Do you have a disability?
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Do you have any long-standing* illness, disability or infirmity?
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* long-standing means anything that has troubled you over a period of time, or that is likely to affect you over a period of time.

Does this illness or disability limit your activities in any way?
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Does this illness or disability affect your?

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Sexuality

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Religion

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Please state?
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In compliance with the Data Protection Act, all information you give will be strictly confidential.


Security Code(*)
Security Code
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