Strivesocial: 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 Strivesocial, it is important to talk about it. Fill out this complaint form below, 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. 


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

  1. by calling us on 0408 707 866 and stating that you wish to make an anonymous complaint (so we don’t ask you to identify yourself); or 

  2. by filling out this Feedback and Complaints Form, but not including your personal details in the table below as these may identify you, and post it to 2 Owen St, Kallista 3791 VIC.

  1. Please provide the following information:

Date

First name

Last name

Telephone 

Email address

I am a

Participant / Family member or friend / Advocate / Carer / Staff member / Other


  1. Are you making this complaint on behalf of a person with a disability?


Yes

No



  1. Do you require any help with communication? e.g. Interpreter or National Relay Service?


Yes

No


If you require assistance, please provide details




  1. Please provide details of your complaint.

Details such as date and time the incident(s) occurred, outline of the issues involved


Details of your feedback/complaint
















  1. Please advise your desired outcome as a result of raising this concern/providing this feedback?














  1. Agreement

I agree that the information provided in this Feedback and Complaints Form is true and correct:



_______________________


Signature




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



The NDIS Commission can take complaints from anyone about:

  • NDIS services or supports that were not provided in a safe and respectful way

  • NDIS services and supports that were not delivered to an appropriate standard


  1. Internal Use Only


Complaint Manager of person responsible for managing complaint

Included in the Complaints Register?

Reference number



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Strivesocial: Advocate or Support Person Request Form

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Strivesocial: Participant Induction Checklist