Complaint Form

Your Information

Complaints on Behalf of Others

Assistance with Complaint

Your Complaint

Desired Outcomes

Overview

Enter your Information

Full Name

Phone

I am a...

Is this complaint being filed on behalf of someone else?

YesNo

Are you being assisted with this complaint?

YesNo

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Complete this section if you are complaining on behalf of someone else

For example, friend, family member, legal representative

Name of person

What is your relationship to that person?

Does the person consent to the complaint being made?

YesNo

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Complete this section if someone is assisting you with the complaint

For example, a family member, your nominee or representative

Name of representative

Organisation

Address

Phone

Preferred contact method

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What is your complaint about?

Please provide details to help us understand your concerns. This may include describing the event or situation, its location, the individuals involved, or any decisions made by the organization that you are dissatisfied with.

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What outcomes are you seeking?

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Review and Submit

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