Complaint Form

Fill in the details of the person who is making the complaint.

Referrer Details

Name of Person

Address

Phone

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

Your Name

What is your relationship to the person?

Does the person know you are making this complaint?

Does the person consent to the complaint being made?

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

Name/Organisation

Contact Details (if known)

What is your Complaint 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 (for example letters, references, emails).

What outcomes are you seeking as a result of the complaint?