Expression of Dissatisfaction about the Police Service

By submitting this form you agree to the information provided being used for case management and any other Policing including Home Office Statistics and assessment.

Complainant Personal Details

Complainant Contact Details

Agent Details (family member, friend or solicitor to act on your behalf)

Complainant Details

What is your Complaint about?

  • - Who was involved?
  • - If there was any damage or injury?
  • - What was said and done?
  • - Summary of your complaint

Complaint circumstances

If your complain relates to discrimination, please tick if it refers to any of the following:

Members of the Police Service subject of complaint

Member 1:

Member 2:

Member 3:

Member 4:

Member 5:

Member 6:

Witness to the Incident

Witness 1:

Witness 2:

Witness 3:

Witness 4:

Witness 5:

Witness 6:



Additional Information

Form Completed By (if done by force)

Equality of Services Monitoring Form

The Police Service is committed to providing Equality of Service in terms of dealing with members of the Public regardless of race, gender, marital status, colour, nationality, religion or belief, ethnic or national origin, sexual orientation, age or disability. This commitment applies to all issues in relation to dealing with members of the public. In order that we may monitor and maintain Equality of Service would you please answer the following questions? However, if you would prefer not to say it will not affect your complaint in any way.