Feedback/Complaint

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Complaints / Feedback Form

Instructions:

Complete this form
The Complaints Manager will contact you upon receipt of this form.

Fill in the details of the person who is making the complaint/ providing feedback.

Name

Address

Phone

Preferred contact method:

Email Phone

If you are making the complaint/feedback on behalf of another person, provide the following details.

Name

What is your relationship to the person?

Does the person know you are making this complaint/providing feedback?

Does the person consent to the complaint/feedback being made?

Who is the person, or the service about whom you are complaining or providing feedback about?

Name

Contact details (if known):

What is your Complaint/Feedback about? Provide some details to help us understand your concerns. You should include what happened, where it happened, time it happened and who was involved.

Supporting Information

Please attach copies of any documentation that may help us to investigate your complaint/feedback (for example letters, references, emails).

What outcomes are you seeking because of the complaint/feedback?