Feedback and Compliants Form

Feedback and Complaints Form
We welcome all feedback, including complaints and compliments. If you have a complaint or concern about your current NDIS supports or services provided by Saircare Support, it is important to talk about it. Fill out this complaint form below, and we will respond to you within three business days.

We will endeavour to keep the information provided in your complaint confidential, unless required by law.

If you wish to make a complaint anonymously by filling out this Feedback and Complaints Form, but not including your personal details in the table below.
Please provide us the following information
Date

MonthDayYear
Date
First name
Last name
Telephone
Email address
example@example.com
I am a:

ParticipantFamily member or friendAdvocateCarerStaff memberOther
Are you making this complaint on behalf of a person with a disability?

YesNo
Do you require any help with communication? Eg. interpreter or National Relay Service?

YesNo
If you require assistance, please provide details
Please provide details of your complaint.

Details such as date and time of the incident(s) occurred, outline of the issues involved
Details of your feedback / complaint
Please advise your desired outcome as a result of raising this concern / providing this feedback?
Details of your feedback / complaint
I agree that the information provided in this Feedback and Complaints Form is true and correct:
Signature

Clear
To make a complaint to the NDIS Quality and Safeguards Commission:

Phone: 1800 035 544 or TTY 133 677 (Interpreters can be arranged) National Relay Service and ask for 1800 035 544 Visit https://www.ndiscommission.gov.au/about/complaints and fill out a complaint contact form

The NDIS Commission can take complaints from anyone about:

NDIS services or supports that were not provided in a safe and respectful way NDIS services and supports that were not delivered to an appropriate standard
Should be Empty:

Feedback and Complaints Form

Please provide us the following information

Please provide details of your complaint.