Your feedback is important to us

We value your voice

Tell us about your experience with our team, the quality of care provided, and any suggestions or comments you may have. Your feedback enables us to continuously improve and tailor our services to meet the unique needs of our clients.

Client Feedback Form


First Name
Last Name
Email Address
Preferred Contact Method
Do you need support to provide your feedback?
Are you providing feedback for someone else?
If Yes, Participants name and relationship and contact number
Service Location:
Staff Member(s) Involved
Date(s) of Incident:
Time(s)
Describe to us what happened
Desired Outcomes
Has this been raised before
Do you have supporting documents
Consent *


First and Last NameBy entering your full name, you confirm that you have read and agree to the consent statements above.
Today's Date

WHAT HAPPENS NEXT

• Acknowledgement within 2 business days
• Resolution aimed within 14 business days
• You may involve an advocate at any time
• You will not be disadvantaged for making a complaint

EXTERNAL CONTACTS

NDIS Quality and Safeguards Commission
1800 035 544
www.ndiscommission.gov.au

Aged Care Quality and Safety Commission
1800 951 822
www.agedcarequality.gov.au


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Share Your Thoughts

Please take a moment to share your thoughts and let us know how we can better serve you. Your feedback is incredibly valuable to us, and we are committed to using it to enhance the care and support we provide.

Thank you for your time and for choosing Holistic Horizons. We look forward to hearing from you and continuing to provide the highest quality of care and support for you and your loved ones.

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