Complaint Form

Make A Complaint

This form will be used to express concerns and record suspicion, allegation or a complaint of unsatisfactory and inappropriate behaviour about the organisation or a representative of the organisation.

Please complete all sections and contact your direct supervisor if you need assistance.

If you have difficulty filling out the online form below you can download a PDF version of the BFS Complaint Form and scan + email to admin@butterfish.com.au

For more information about NDIS Quality and Safe Guards Commission complaints please visit the NDIS Quality and Safeguards Commission Website.

Name

Phone Number

Email Address

Names of persons involved

Name of person making the compliant

Name of the person whom the complaint is made against

Nature of the complaint - Please include time, date, location and what happened

Details of what happened

Details of injuries sustained and if the person received medical attention

Accurately as possible record what the complainant said when describing what happened.

Provide details of anyone who witnessed what happened

Does this complaint indicate the possibility of abuse?

Further steps to be taken by Butter Fish Services to resolve the matter

Is any follow up required?

If yes please provide details

Complaint Form

Make A Complaint

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