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You are here: Home » Your City Council » Contact Us » Tell Us What You Think » Customer Feedback - Online Form

Tell Us What You Think

To make a complaint, comment, suggestion or compliment, please fill in this online form.

See Customer Feedback - FAQ's for guidance.

» Required Fields

» Name:

» Address:

» Postcode:

Date of Birth:

Daytime telephone number:

Evening telephone number:

Email:

» Which part of the council's service is your feedback about?

» What happened/did not happen?

» How have you been affected by this?

» What do you think the service should do?

» Have you given us feedback about this previously?

Yes
No

If yes, please state when and to whom:

Extra Information about you

The information requested below is optional and we will respond to your feedback whether or not you answer these questions.

Your answers will help us to ensure that we provide fair and continuously improving services for all our customers, and will only be used by us for monitoring and assessment purposes.

Gender:

Male
Female

Do you consider yourself to be disabled?

Yes
No

Ethnic Origin:

British
Irish
Any other white background

Please state:

Asian or Asian British:

Indian
Pakistani
Bangladeshi
Any other Asian background

Please state:

Mixed:

White & Black Caribbean
White & Black African
Any other mixed background

Please state:

Black or Black British:

Caribbean
Somali
African
Any other black background

Please state:

Other ethnic groups:

Chinese
Yemeni
Any other

Please state:

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Generated: 20/12/2006 | Modified: 21/11/2007 by Web Administrator

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