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 Disability and Mental Health Care Pty Ltd, it is important to talk about it. Fill out this complaint form 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.

Making a complaint anonymously

If you wish to make a complaint anonymously, you can do so:

• By calling us on 0488 114 368 and stating that you wish to make an anonymous complaint (so we don't ask you to identify yourself); or
• By filling out this Feedback and Complaints Form, but not including your personal details as these may identify you.

Your details

• Date
• First name and last name
• Telephone and email address
• I am a: participant, family member or friend, advocate, carer, staff member, or other
• Are you making this complaint on behalf of a person with a disability? Yes / No
• Do you require any help with communication, for example an interpreter or the National Relay Service? Yes / No — if you require assistance, please provide details

Your complaint

• Details of your feedback or complaint, including the date and time the incident or incidents occurred and an outline of the issues involved
• Your desired outcome as a result of raising this concern or providing this feedback

Agreement

I agree that the information provided in this Feedback and Complaints Form is true and correct, signed by the person providing it.

Complaining to the NDIS Commission

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

• Phone 1800 035 544 or TTY 133 677 (interpreters can be arranged).
• Use the National Relay Service and ask for 1800 035 544.
• Visit the NDIS Commission's complaints page at ndiscommission.gov.au 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, or that were not delivered to an appropriate standard.

Internal use

The office records the Complaint Manager or person responsible for managing the complaint, whether it has been included in the Complaints Register, and the reference number.