Your feedback is really important to us. Please help us improve the way we provide our services to you, and learn when things go wrong.

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Title:
Dr Mr Miss Mrs Ms

Name:


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I wish to make a:

Comment Complaint Compliment

	Electoral registration, telephonists, reception, legal services, recruitment
	Education (with the exception of schools which are handled directly by the school concerned)
	Children’s social services
	Street cleaning, refuse collection, street lighting, parking, green spaces, trees, planning, environmental services, trading standards, bereavement services
	Council tax, business rates or housing benefits
	Council housing, including repairs for council properties
	Adult social care, leisure services, libraries
	Other

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What action would you like taken?


If you have already spoken to a Council staff member, please give details:

• you will receive an acknowledgement within 2 working days
• you will receive a full response within 10 to 20 working days

We are keen to make sure that everyone in Lewisham is treated fairly and can access our services easily. In order to ensure that this is happening, please take a few minutes to answer the following questions.

The information provided will be used strictly for statistical purposes only and will be treated in the strictest confidence.

Please select how you would describe yourself from the boxes below.

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Your ethnic background would be best described as:

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	Asian: Indian, Pakistani, Bangladeshi, other Asian background
	Black or Black British: Caribbean, African, other Black background
	Chinese: Chinese, other Chinese background
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Disabilities
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