Online Feedback and Complaint Form

We are here to assist you!

Please complete the form below to express your feedback and/or complaint.
Date of filling the form:

MonthDayYear
Date
Name of person completing the form (you can choose to remain anonymous if preferred:
Please leave this blank if you wish to remain anonymous
E-mail
Please leave your email address if you wish to receive details regarding the outcome of the feedback or complaint
This form is regarding a: (please choose one)

ComplaintGeneral feedback

Please describe your feedback OR complaint:
Name of the Stepping Stones Therapy Services staff member/s involved with the feedback OR complaint:
The action that you would like to see Stepping Stones take in regards to the feedback OR complaint is:

Thank you for completing this form
In receiving feedback or a complaint, Stepping Stones Therapy Services will:
1. Acknowledge receipt of the feedback or complaint within five (5) working days where possible, and if a response has been requested.
2. Investigate the issue raised and decide on any actions or improvements that may be required.
Once we have completed this internal review we will respond to you in writing (if you have provided contact details) within thirty (30) days, detailing the steps of the review process and the outcome. If the matter cannot be resolved during this time, Stepping Stones Therapy Services will advise you of the reasons for the delay and provide a revised timeframe; ensuring appropriate records are maintained in accordance with Stepping Stones Therapy Services policies and procedures.
Should be Empty:

We are here to assist you!