Pacific Smiles Group Whistleblower Form

At Pacific Smiles Group, we take all reports of unethical or improper (reportable) conduct very seriously, with complaints being managed confidentially and swiftly.

Reportable conduct (also referred to as "Unacceptable Conduct") is conduct that constitutes an offence against, or a contravention of, a provision of any of the following: the Treasury Laws Amendment (Enhancing Whistleblower Protections) Act 2018; the Australian Securities And Investments Commission Act 2001; the Banking Act 1959; the Financial Sector (Collection of Data) Act 2001; the Insurance Act 1973; the Life Insurance Act 1995; the National Consumer Credit Protection Act 2009; the Superannuation Industry (Supervision) Act 1993; or constitutes an offence against any other law of the Commonwealth that is punishable by imprisonment for a period of 12 or more months. Examples may include:

financial irregularity (including a fraud against PSG or a customer or supplier)
corrupt conduct
criminal conduct
failure to comply with any legal or regulatory obligation
unfair or unethical dealing with a customer
unethical or other serious improper conduct, including breaches of PSG policies
misconduct, or an improper state of affairs or circumstance
danger to the public or financial systems

Reportable Conduct does not include any personal work-related grievances.

This form allows you to report unacceptable conduct you believe is occurring in any Pacific Smiles Dental location. You have the option to raise your concerns anonymously or to provide your contact details to us.

Should you wish to refer to it, the PSG Whistleblower Protection Policy can be found here: PSG Whistleblower Policy

What do you believe the reportable conduct is most applicable to?*

Breach of PSG policyCorrupt conductCriminal ConductDanger to the publicFinancial (Financial Fraud against PSG, Customer or Supplier)Misconduct, or an improper state of affairs or circumstancesUnfair or unethical dealings with a customerOther

Name/s you believe are engaged or involved in reportable conduct*

What are the specific facts or details, including dates and times, that relate to the reportable conduct?*

0/5000

How did you become aware of this reportable conduct?*

0/5000

Does this reportable conduct involve a thirdparty (ie supplier)?

Please attach any supporting documentation:

Browse Files

Name of person submitting report (voluntary):

Email (voluntary):

example@example.com

Phone Number (voluntary):

If this is an anonymous report, do you understand you may not be able to be contacted to be advised of the outcome?*

YesNo

By completing and submitting this form you understand and agree that this is a confidential matter and should not be discussed with colleagues or outside the company.

PSG Whistleblower Form