Lodge a Complaint Δ Your Name First Last Your Address Street Address City State Postcode Your Phone Number (if you would like us to respond)Your Email Address (If you would like us to respond) Do you receive NDIS Funding?(Required) Yes, I receive NDIS Funding No, I privately fund my sessions We welcome all feedback, including complaints and compliments. If you have a complaint or concern about your current NDIS supports or services provided by The Abbwell Group, 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: by calling us on 07 4179 0730 and stating that you wish to make an anonymous complaint (so we don’t ask you to identify yourself); or 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 33 Cunnington Street, Bundaberg East QLD 4670. I am a(Required) Participant Family member or friend Advocate Carer Staff Member Other Complaint DetailsAre you making this complaint on behalf of a person with a disability?(Required) Yes No Do you require any help with communication? e.g. Interpreter or National Relay Service?(Required) Yes No If yes, please provide details of assistance with communication required(Required)Which service does your complaint relate to?(Required)Bundaberg Equine Assisted TherapyAbbwell Counselling ServicesAbbwell Equine ServicesAbbwell Care ServicesMens' Speak OzDate of the Incident(Required) DD slash MM slash YYYY Time of the Incident(Required) Hours : Minutes AM PM AM/PM Location of the Incident(Required)Description of the Incident(Required)ResolutionYour Desired Resolution(Required)Supporting DocumentationPlease attach any relevant documents or evidence that support your complaintUpload your Files Here Drop files here or Select files Max. file size: 2 GB. Consent & SubmissionConsent I confirm that the information provided is true and accurate to the best of my knowledgeDate Submitted(Required) DD slash MM slash YYYY To make a complaint to the NDIS Quality and Safeguards Commission: Phone: 1800 035 544 or TTY 133 677 (Interpreters can be arranged) National Relay Service and ask for 1800 035 544 Visit https://www.ndiscommission.gov.au/about/complaints and fill out a complaint contact form 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 CAPTCHA
