Feedback and Complaints Form

Feedback and Complaints Form
What is the nature of the feedback? :

Comment Complaint Compliment Appealing an outcome decision from a complaint or feedback
Would you like to remain anonymous or would you like to receive our response to your feedback? ( Your privacy and confidentiality will be respected at all times. SILC collects personal information from you in order to respond to your feedback, and provide you with details of any action we may take in response. If you do not provide your personal information, we will not be able to send you a confirmation of the receipt of your feedback. It may also affect how we handle your feedback/ complaint)

I have provided by name and contact details below for a response I prefer to remain anonymous
Name of person completing form

First Name Last Name
Email
example@example.com
Phone Number

Area Code Phone Number
What is it about?
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.
Details of feedback
Do you (or a family member, or the person you are representing) receive services from SILC?
Preferred response method
Should be Empty: