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Complaints and Appeals Form
The following is a cover sheet to support your complaint/ appeal. It is to outline your complaint / appeal and you are to attach any supporting documentation.
Please indicate what your grievance is (tick the appropriate box below):
*
Complaint - Initial notification of your dissatisfaction or an issue that has occurred
Appeal - Application to have the outcome of a complaint reviewed due to dissatisfaction with the process or an assessment decision
Date of submission:
Name of Complainant:
*
Describe the nature of the Complaint / Appeal:
*
Describe the specific incident that caused concern/distress. Please describe exactly what occurred, when it occurred, and who was involved (If there is not enough space to fully record your complaint/ appeal here then please use the reserve of this paper to add further details).
(Please provide more information on separate pages if required.)
What action have you taken to try and resolve this complaint / appeal?
Do you have a suggested remedy to the problem?
I hereby declare that the information provided on this form is true and correct.
Signature:
Date:
RTO Personnel who received this document in the first instance:
Title:
Name:
Signature:
Date:
RTO Manager to complete:
Date received:
Name:
Signature:
Notes and comments regarding how the complaint has been dealt with and outcome of complaint:
Submit