Complaint Record Form

Details of person making the complaint
Note: This form can be completed electronically or by hand.

IF YOU LODGE A COMPLAIN ON BEHALF OF SOMEONE ELSE PLEASE COMPLETE THIS SECTION
Date complaint received:

Does the person making the complaint wish to remain anonymous?YesNo

(if participant is not the person making the complaint)

Participant details

Is the participant an existing client?

YesNo

(if complainant is not the participant)

Complaint details

Current status of complaint:
InvestigatingAction proposedResolved