Online Complaint Form

Important security information

Please be aware and consider your privacy as this online form is not secure.

To protect your privacy, personal information and/or confidential information should not be communicated using this form. You should only provide information that will assist us with your complaint.

What is personal information?

Personal information is information that you provide to us which personally identifies you or your clients, such as full names, client record information, financial information or other data that can be reasonably linked to such information.

What is confidential or sensitive information? 

Confidential or sensitive information includes confidential medical information, information about racial or ethnic origins, political or religious beliefs or sexuality and is tied to personal information.

If you have any concerns about using this form, please contact us on 1800 880 052.

Your details

First Name (required)

Last Name (required)

Organisation

Gender

Male

Female

Other

Phone (required)

We need your phone number so that we can contact you about your complaint.

Email (required)

State (required) - Select -Australian Capital TerritoryNew South WalesVictoriaQueenslandWestern AustraliaSouth AustraliaTasmaniaNorthern Territory

Your complaint

Status (required) - Select -New complaintExisting complaint with your service providerExisting complaint involving another party

Nature of your complaint (required) - Select -Disability Employment Service ProviderAustralian Disability EnterpriseAustralian Government-funded advocacy serviceHuman rights issueEqual opportunity issueAlleged criminal actOther

Service Name (required)

Service Location (required)

Details of your complaint (required)

Leave this field blank

Last updated: 30 May 2023 - 11:10am