Make a Complaint

Make a Complaint

Please note: Before you make a complaint, please read the information here carefully. If you are unsure and want advice, contact us.
This form is to be used only if you wish to lodge your complaint electronically. If we require further information, we will contact you.

    Part 1: Complainant

    MrMrsMsDrOther
    Do you need an interpreter?
    If yes, please let us know which language and dialect you prefer

    I am making a complaint:

    for myselffor someone else

    I authorise the Commissioner to obtain and share information and personal records relevant to my complaint with the service provider. For more information, click here. Proceed to Part 2.

    Before you proceed, please answer the questions below and then proceed to Part 2.

    Has the person who received the service given you permission to make a complaint on their behalf?
    YesNoThe person who received the service is deceased

    Do you have a legal role for the person who received the service? (for example, parent of a child under 18, guardian)
    YesNo

    Do you agree that we can talk about this complaint with the person who received the service?
    YesNo


    Part 2: Details of the person who received the service

    MrMrsMsDrOther
    Do you identify as (optional)
    AboriginalTorres Strait IslanderBothOther
    Country of Birth?

    Part 3: Details of the service the complaint is about

    Tell us about the complaint

    How I would like my concerns resolved?
    Information/ExplanationAccess serviceRefund/CompensationApologyAdequate serviceChange Policy/ProcedureTraining/education for the workerOther
    Have you already tried to resolve your complaint directly with the service provider?
    YesNo
    Have you made your complaint to another person or organisation? (for example – an advocate, a lawyer, MP or other complaints organisation)
    YesNo

    Part 4: Attaching additional documents

    Acceptable file types: doc,docx,rtf,pdf,txt,gif,jpg,jpeg,xlsx,xls,png,txt.

    Maximum file size: 10mb.

    Part 5: Completion and lodgment

    Please read our disclaimer.

    If you want to keep a copy of this form print it out now.

    Other HCSCC resources can be downloaded from HCSCC Resources and publications.

    Print Version

    Please download our complaint form (print version) if you would like to lodge your complaint with HCSCC in a hard copy format.
    If you need help to fill in this form, please contact the HCSCC Assessment Service.

    Download