Neta Care Feedback Form

Feedback Form
Our service is committed to providing high quality care and services and meeting your needs.

We value your feedback. Please let us know what we do well and where we can improve our services.

If for some reason, you have a problem with this form, please call our office to speak directly with our staff, who can assist you.
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You may choose to remain anonymous. Be advised: If making a complaint, a manager will contact you to confirm receipt, advise you of the outcome of actions taken, and ensure that you are satisfied with the outcome. This will take place within the space of one month from receipt. If you choose to remain anonymous, it will not be possible for the manager to contact you as part of this process.
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Feedback made on another person's behalf

Please provide the details about the person on whose behalf you are acting.
Name

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Phone Number

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Email Address
example@example.com
Address

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Are you a legal representative for the person who received the service? (e.g. parent of a child under 18 years or guardian)
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Does the person know you are filling out the feedback form on their behalf?
If no, please state the reason why.
Are we able to speak with the person who received the service?
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This question may only be completed with the express permission of the person whose information is being supplied.
Feedback details

Please provide details that the feedback concerns.
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This feedback is about
Feedback
Please provide details of your main topic of feedback, including what events led to making the feedback, approximate dates and who was involved.
Have you discussed this with anyone or any Neta Care department or any agency?
If yes, with whom, and what was the outcome?
What outcomes would you like as a result of this feedback?
Consultation Feedback
What is the consultation feedback in relation to?
Please provide summary of your feedback:
Privacy notice
Neta Care Holistic Health Services (NCHHS) is committed to protecting your privacy. We collect and handle personal information that you provide on this feedback form for the purpose of investigating and responding.

NCHHS will only use your information in accordance with relevant privacy and other laws. In order for us to provide services to you effectively and efficiently, we may need to share your personal information with others, such as staff who deal with the matters identified in your feedback.

If you choose to remain anonymous, NCHHS may be unable to deliver the full range of services you require.

If you wish to contact NCHHS, who are responsible for managing the personal information that you provide on this form, please call 1300 389 562.

You also have the right to access your information and seek its correction under the Freedom of Information Act 1982. For information about making a Freedom of Information application contact the Compliance Team on 1300 389 562.
Declaration & submit feedback
Please check the box below to confirm the information you have provided in this feedback submission is true and accurate.
Thank you for taking the time to provide feedback about our service.
Please check the box below to indicate you have read and agree to this privacy notice.
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Feedback Form

Your details

Feedback made on another person's behalf

Other person’s consent for feedback made on their behalf

Feedback details

Feedback

Consultation Feedback

Privacy notice

Declaration & submit feedback

Thank you for taking the time to provide feedback about our service.