Response Service Comments

Are you using this form to tell us about a (choose one):

compliment
comment
complaint
representation (concern)
appeal

Are you writing...

as an individual
on behalf of someone else

If you are writing on behalf of someone else, do you have their permission?*

yes
no

Would you like us to help to arrange an advocate? Sometimes it helps to have someone else who can speak on your behalf and represent your interests, especially in formal situations, or when you don't feel very confident. They can help you get your views or wishes across. A person who speaks up on your behalf in this way is called an ‘advocate’

yes
no

Which service or department does this relate to?

Education - Special Educational Needs
Family & Children Services – Social Care
Other (please specify below)

If you answered "other" to the above question, please specify which department here

Please enter your details below.

Name*

Address*

Post code

Email address

Tel (daytime)

Tel (evening)

Mobile

Have your say here. Try to include as much information as possible – names, dates etc. If you are writing on behalf of someone else, you can include their name and address here.*

Is there anything you would like us to do?

How would you like us to contact you?

email
letter in the post
telephone
other

If you answered other to the above question, please give details:

Have you already reported your comments?

yes
no

If yes, what was the name of the staff member or office you have reported it to?

Data Protection Notice: The personal information that you have provided will be handled by Royal Borough of Kensington and Chelsea in line with the Data Protection Act 1998 and will only be used for the purpose of processing your comments. Your information will not be used for any other purpose. This information will not be disclosed to any other parties, including other Council departments and outside individuals or bodies

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