Recommendation/Complaint Form

Name and Address of Recommendation / Complaint:

Type of Business:
Restaurant Sports Facility Cinema Theatre Museum Council Offices Retail OutLet Other Please Select

Access Information

Was the building accessible by a Wheelchair User?
Yes No

Were there Wheelchair accessible Toilets?
Yes No

Was there suitable and Accessible Parking facilities?
Yes No

Did they cater for Visual and/or Hearing Impairments?
Yes No
Please provide details

Were the Staff helpful
Yes No

Please give any other details you think may be relevant

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About Yourself

Name (Optional):

Address (Optional):

Age Group:
Under 25 25-40 41-60 over 60

Do you have a Disability?
Yes No
If Yes, please give details

Do you live in any of the following areas?
Doncaster South Yorkshire Other

Please enter your email address:

Where did you hear about our site?
Search Engine DiAL Poster Word of Mouth DiAL Staff Listing on another Web Site Other Please Select

If you found us on a Search Engine, please could you enter which one