General Complaint Form

Required fields are marked with an asterisk (*).

Contact Details

Name *

Phone Number Enter your contact number without spaces

Email *

Address line 1

Address line 2

Suburb

Postcode Enter your postcode without spaces

General Complaint Details

Please tell us what happened and the nature of your complaint *

Date of occurrence *

Day Month Year

Name of the employee or department if relevant

Where did the incident occur (street, reserve, address etc)

Do you think the matter can be resolved to your satisfaction? If so please tell us how.

Acknowledgement