Feedback and Complaints

Feedback and Complaints
Date

Month Day Year
Date Date Picker Icon
Name of person completing form

First Name Last Name
Is this:

Feedback A Complaint
Mode of feedback or complaint

Phone Email Written Verbal JotForm
Type of feedback or complaint

Staff Board Policy Work Health and Safety
Select all locations this feedback or complaint relates to

SILC Head Office PaRA Co-operative Ltd. TK Assisted Living Co-operative Ltd. My House Oatlands Inc. Jia Home Co-operative Ltd. CESIL House Co-operative Ltd. Kieran and Matt's Place Ltd. Emet House Co-op Ltd. JTeam Inc. Anarchy House Co-operative Ltd. Charis House Co-operative Ltd.
Nature of the feedback or complaint
Complaint Risk Ratings

High: Complaint is of a serious nature and will be managed by the Co-operative Board and escalated to SILC Board for noting

Medium: Complaint will be managed by House Manager or Co-operative Board

Low: Complaint can be managed by response from House staff
Risk rating

High Medium Low
To be completed by SILC after submission
Name of person who received the complaint/feedback

First Name Last Name
Actions taken and resolution
Should be Empty: