COMPLAINT ENQUIRY FORM                                                               [Entwo For Enfield]

 


Unique Reference Number:

 

 

Date of referral                     

 

 

Method of referral                 Website     Telephone     Email     Letter     In person

 

Referral received by             _________________________________________

 

COMPLAINANT DETAILS

Full name

 

 

Organisation (if applicable)

 

 

Address including postcode

 

 

 

 

 

 

Email address

 

 

Landline

 

 

Mobile

 

 

Choose type of complainant

·       Affected party

·       Representative Group

(public interest)

·       Third party (accuracy)            

  

 

Preferred means of contact

·       Email              

·       Telephone

·       Letter              

·       Through agent only

Adjustments required (e.g. the complainant is hard of hearing and needs written communication)

 

 

 

 

 

 

 

 

 

 

 

ARTICLE DETAILS

Name of publication

 

 

 

Headline of published article

 

 

 

Link, reference to or copy of offending publication

 

 

 

COMPLAINT DETAILS

 

Summary of complaint (50 words)

 

 

 

 

 

 

 

 

 

Reference to specific phrases/words or sections of the article that the complainant believes to be in breach of the Standards Code

 

 

 

 

 

 

 

 

Standards Code clauses that the complainant believes to have been breached

 

 

 

 

 

Outcome or remedy requested