Participant Complaint Form
Please utilise this form if you are experiencing issues with Boundless Support Services, including but not limited to, a support worker, a process, our service delivery or anything else relevant to us as your support provider.
Personal Details
Date
-
Month
-
Day
Year
Date
Participant name
First Name
Last Name
If applicable - Participant representative
First Name
Last Name
Phone Number
Please enter a valid phone number.
How has this complaint been communicated - In person, online, via phone etc.
Name of person submitting this form
First Name
Last Name
Complaint details
Who is this complaint being made against or about?
What is your complaint?
Where did the above occur? (Location, address)
Name/s of people/s involved
Outcome
What actions have you already taken to resolve this issue (If any)
What is your preferred outcome?
Signature
Please note that all complaints received by Boundless Support Services will be treated with respect, confidentiality and will not impact your service delivery with us. We will endeavor to get back to you with an outcome as soon as possible and remain in contact throughout any investigations.
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