This form allows NDIS participants, their families, carers, or advocates to submit complaints, feedback, or compliments. Fields marked with * are required.
What type of feedback are you submitting? * 🔊
ComplaintFeedbackCompliment
Are you submitting this anonymously? * 🔊
YesNo
First Name * 🔊
Last Name * 🔊
NDIS Number (if applicable) 🔊
Email Address * 🔊
Phone Number (optional) 🔊
Postcode * 🔊
Are you submitting on behalf of someone else? 🔊
Representative Name 🔊
Organisation (if applicable) 🔊
Relationship to Participant 🔊
Contact Details 🔊
Date the issue occurred * 🔊
Location of incident or service * 🔊
Who was involved? (optional) 🔊
Description of complaint, feedback, or compliment * 🔊
What would you like to happen as a result of this submission? (optional) 🔊
Do you consent to Dash Group contacting you regarding this submission? * 🔊
