Complaints form

Raise a concern confidentially.

Please complete the form below to send a complaint to Charnwood Knoll. Personal data submitted through the form is handled as described in the privacy notice.

Confidential handling This form is sent to Charnwood Knoll, Office 5, The Forest Rock Offices, Leicester Rd, Whitwick, Coalville, LE67 5GQ. Please keep a copy for your own records before sending.

Name Date of complaint

Address

Email address Use a full email address, including the @ symbol. Phone number optional

Nature of complaint - Part 1 Nature of complaint - Part 2 Response or next step you are seeking

Signature Date signed

I confirm that this complaint is being sent to Charnwood Knoll at Office 5, The Forest Rock Offices, Leicester Rd, Whitwick, Coalville, LE67 5GQ, and that I will keep a copy for my own records.