COMPLAINTS AND FEEDBACK

With this form Down Syndrome NSW allows individuals a structured process for managing & resolving complaints and feedback, this can assist to improve the quality of services being offered, identify areas of improvement and build trust & confidence with customers. This demonstrates our commitment to transparency, accountability & continuous improvement.

Name: *

Email Address *

Contact Number:

Type of feedback: *

ComplaintSuggestionComplimentOther

Description of feedback, complaint, suggestion, other:

Date of incident (if applicable):

Staff member involved (if applicable):

Signature of person making complaint or giving feedback

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DSNSW ACTION

Action taken

Resolution status:

OpenResolvedPendingOther

Additional comments:

Follow up actions required:

Date follow up required (if applicable):

Responsible staff member:

Date follow up complated:

Follow up results

Manager's comments:

Signature of complaint/feedback receiver:

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