Name of complainant *
Choose whether *
Tenant
Former Tenant
Applicant for housing
Other (please specify)
Please enter your address and postcode
Address 1
Address 2
Postcode
Contact phone number *
Your email *
Have you previously reported this matter?
Yes
If yes, who has been dealing with your enquiry?
Details of complaint, including date(s) when acts or omissions complained of took place and manner in which complainant has been adversely affected *
Please suggest how you would like the complaint to be remedied *
About You
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Are You
Male
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Age
under 20
20-25
26-34
35-43
44-52
53-59
60-64
65-74
75+
Belief/Religion
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Do you consider yourself to have a disability?
Yes
No
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