Customer Support

Customer Complaint Form Template

A customer complaint form is a form that records what went wrong, when and where it happened, and what the customer wants done about it so a business can investigate fairly and respond within a set time. This template asks for the desired resolution in plain options (refund, replacement, apology, repair) so you know the customer's expectation before you pick up the phone.

Use this template — freeTry it first
12 questions
One page
~3 min
To fill in
Single layout
Mobile-ready
Free
No credit card
Customer Complaint form beside a photo of a barista serving a customer at a cafe counter

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Photo by Mizuno K on Pexels

Who it's for

Retail stores, restaurants, hotels, service companies, clinics' front offices and any business that needs a written complaint log for quality or regulator reviews.

  • A complaints link in order confirmation and receipt emails
  • A QR code at the till or reception for in-person complaints
  • Logging phone complaints so staff record every case the same way
  • Building a monthly complaints register for quality reviews

What this template asks

Every question can be changed, removed or reordered once it's yours.

  1. Full name*

    Short text

  2. Email*

    Email

  3. Phone number

    Phone number

    Optional

  4. Order, booking or receipt number

    Short text

    Optional

  5. When did it happen?*

    Date

  6. Store, branch or location

    Short text

    Optional

  7. What is your complaint about?*

    Multiple choice

    • Product quality or fault
    • Delivery or delay
    • Staff behavior or service
    • Billing or overcharge
    • Website or app
    • Other

  8. What happened?*

    Long text

  9. Photos, receipts or documents

    File upload

    Optional. Up to 4 files

  10. What would put this right for you?*

    Multiple choice

    • Full refund
    • Partial refund or credit
    • Replacement or redo
    • Repair
    • An apology and explanation
    • Other

  11. Have you raised this with us before?*

    Multiple choice

    • No, this is the first time
    • Yes, once
    • Yes, more than once

  12. How should we contact you?*

    Multiple choice

    • Email
    • Phone call
    • Either

Tips for more responses

  1. 1

    Turn on the email copy to the respondent so the customer gets a dated record of their complaint straight away.

  2. 2

    Use the per-question charts to spot patterns, such as most complaints coming from one location or one type of issue.

  3. 3

    Edit each response to log your outcome; the edit history shows who updated the case and when, which helps if a complaint is escalated.

Questions

What should a customer complaint form include?

The customer's name and contact details, the order or reference number, the date and location of the problem, the type of complaint, a description of what happened, any evidence such as photos or receipts, the resolution they want and their preferred contact method.

How quickly should a business respond to a complaint?

Many businesses acknowledge a complaint within one or two working days and aim to resolve it within two to four weeks. Some industries have formal deadlines set by a regulator, so check the rules that apply to your sector and location.

Why ask customers what resolution they expect?

It tells you up front whether the customer wants a refund, a replacement, a repair or simply an apology. Knowing that makes the first reply more useful and often settles the complaint faster.

Should I keep a record of complaints?

Yes. A complaints log helps you spot repeat problems, train staff and show auditors or regulators how complaints were handled. Exporting responses to Excel or CSV gives you that log without retyping.

Is this customer complaint template free?

Yes. Copy it into a free Dculus Forms account, change anything you like and start collecting responses. No credit card is needed.

Can I change the questions?

Yes. Your copy opens in the form builder, where you can add, remove and reorder questions, change the layout and add your own branding.

Where do the responses go?

Responses arrive in your Dculus Forms workspace. You can export them to Excel or CSV, send them to Google Sheets or a webhook, and get email notifications.

Can I host it myself?

Yes. Dculus Forms is open source (GPLv3), so you can run it on your own servers and keep every response in your own database.

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