Feedback and Complaints Form

At BBWSS, we value your feedback. Your input helps us to improve our services and ensure we meet your needs. This form can be for compliments, suggestions, or complaints.

Clients Details (optional)

Name:

NDIS Number (if applicable):

Contact Number:

Email Address

You may remain anonymous if you prefer. However, if you would like us to respond, please provide contact details.

Type of Feedback:

ComplimentSuggestionComplaint

Service Area (tick all that apply):

Personal CareDomestic AssistanceCommunity ParticipationSocial Support

Other:

Details of Feedback / Complaint

(Please describe your experience, including dates, times, and staff involved (if relevant): *

Desired Outcome

(What would you like to see happen as a result of your feedback) :

Consent

I give permission for BWFSS to contact me regarding this feedback.I would like to remain anonymous.

All feedback and complaints will be reveiwed by two designated BWFSS staff members to ensure fairness and transparency in the resolution process.

Office Use Only

Date Received:

Actions Taken:

Outcome/Resolution:

Reviewed & Signed Off by Administration/Service Delivery Office: *

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Reviewed & Signed Off By CEO: *

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Date Completed: