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Customer Complaint Form

Little Helpers is committed to customer satisfaction and we want to know if your not
happy with the quality of service. We ask that you please send us your complaint in
writing. You can use this page to complaint your complaint or print this page and fax
it to us at 866-803-4286.

* Required Field

Full Name:

Address:

Phone:

E-mail:

Appointment Date and Time

I would like to complain about:

How can we rectify the issue:

We will look in the issue and a staff member will get back to you by e-mail and
or phone. Your satisfaction is our goal! We do apologize for any issues you
may have faced.

Please include details below: