Complaint Form 
​We value your feedback and are committed to resolving your issues in a fair, timely and efficient manner.

If you believe we have given cause for a complaint by way of a breach of any of our contracts, terms and conditions or codes or conduct/practice, consumer laws or in another manner please provide a detailed explanation below so we can do our best to address and resolve the issue.

This is available for clients, customers and team members to use.

Clint, Aimee and the Team
Sign in to Google to save your progress. Learn more
Your full name: *
Your email address: *
Today's date: *
MM
/
DD
/
YYYY
The type of service / product your complaint is regarding (Private Kids Coaching, e-book purchase, event attended, team training sessions etc): *
Date the issue/incident took place (if relevant):
MM
/
DD
/
YYYY
Full name/s of Autism & Beyond team member/s the complaint is in relation to: *
Please provide as much detail about the nature of the complaint as possible: *
What resolution would you like as a result of making this complaint? *
Are you happy for Autism & Beyond Management or a Senior Team Member to contact you via a phone call to discuss further? If Yes, please provide your phone number in the next question. *
Your phone number:
Thank you for your feedback. We will respond via email as soon as we possibly can with the aim of resolving this issue as best we can.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Primal Influence. Report Abuse