Customer Complaints Worksheet

* FIELDS HIGHLIGHTED IN YELLOW ARE REQUIRED

WORKSHEET
Date:	1/7/2009
Contact Name/Title:
Customer Name:	Customer No:
Address:
City:	State:  Zip Code:
Phone:	FAX:
E-mail:
Reference - Customer Document:
Reference - QED/inc Document:
Customer Complaint Category:	Nonconforming product Inadequate packaging / Transit damage Late delivery Insufficient / inadequate quality records, etc. Outstanding corrective action issues Communication / Responsiveness Miscellaneous
Specifics of the customer complaint (Attach and number customer & QED documents):