Customer Complaint Non-Conformance Form
Reference Number
Date
Received By
Customer Name
Contact Information
Product/Service Involved
Complaint Description
Type of Non-Conformance
Severity
Minor
Major
Critical
Investigation
Investigated By
Investigation Date
Investigation Details
Root Cause Analysis
Corrective/Preventive Action
Correction/Immediate Action
Corrective/Preventive Action Taken
Action By
Action Date
Verification of Effectiveness
Verified By
Verification Date
Verification Details