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Run: Customer Complaint Intake Form

Capture customer complaints, order issues, and requested resolutions in one structured intake form. Use it to route follow-up quickly, keep records consisten...

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Customer Information

Customer name (required)

Preferred contact email

Preferred contact phone

Preferred contact method (required)

Complaint Details

Date of complaint or issue (required)

Type of issue (required)

Order number or reference ID

Enter the order or case reference if available. Do not include payment card details.

Describe the issue (required)

Include what happened, when it happened, and any relevant context.

Where did the issue occur?

Requested Resolution

Requested resolution (required)

Additional resolution details

Use this field if the customer wants a specific amount, replacement item, or other details.

Desired timeline for resolution

Attachments and Follow-Up

Supporting files

Upload photos, receipts, screenshots, or other relevant documents.

Additional notes

Add any other information that may help with investigation or follow-up.

Submit anonymously

Select this if you do not want to provide contact details. Anonymous submissions may limit our ability to follow up.

Yes No N/A

Get your results

Enter your email — we'll send you a PDF of your filled-out template. We won't sign you up to anything; you can opt in to the trial from the email if you want.

Email (required)

Your name (optional)

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