COMPLAINT FEEDBACK FORM

Please fill in the Complaint Feedback form on this web page and submit.

Alternatively, if you want to fill it manually, please Click Here to download the the form and email us completed.

COMPLAINT FEEDBACK FORM

Part A - Your information.

PartB - Information about the complainant ( if different to above)

Fill in the section if you are complaining on behalf of someone else.

Fill in the section if someone is assisting you with the complaint - for example a family member, your nomine or representative

Contact Numbers:

Part - C Detail about your complaint

What is your complaint about?

Part D - Who is your complaint about?

Name of the person or service about whom you are comlaining ( the respondent or the agency person who made the decision)

Contact Numbers:

NOTE: If tou want to complaint about more than one person or organisation, please this additional information.

Part E - Further information.

Supporting information

Have you made a complaint about this to another agency?

For example: a disability  service or equal opportunity agency, Health Care Complaints  Commission, Ombudsman)