Online Complaints

If you submit an open complaint we will know your identity. You will be kept informed about the progress of your complaint and you will have review rights.

I have read the Notice of Collection

Your Details

Would you like to be anonymous
NoYes

Your Name *

Street Address *

City/Town/Suburb

State/Territory

Post Code

Your Email

Would you like to be kept up to date
NoYes

Phone

Preferred contact method

Complainant Information

My complaint relates to: *
The care or services I am receivingThe care or services someone else is receiving

Details of Person Receiving Care

If this complaint relates to the care and services a specific person is receiving, you may add their details here

Name

What is your relationship with the person receiving care?

Is the person receiving care aware of this complaint?
NoYes

Does the person receiving care consent to this complaint being raised?
NoYes

Are you authorised to make decisions on behalf of the person receiving care?
NoYes

If you have a copy of the instrument or order which authorises you to make decisions on behalf of the care recipient
Please upload it in the file upload section further down on this page.

Details of your complaint

Complaints can relate to care, financial matters, hygiene, equipment, security, activities, choice, comfort and safety or other matters related to the responsibilities of an service provider. We cannot provide advice on who can make financial and medical decisions on behalf of a person receiving care and cannot provide legal advice. If we cannot help you, we will try to refer you to someone who can (unless you have submitted an anonymous complaint).

Have you discussed your complaint with your Care Co-Ordinator? *
NoYes

Have you contacted anyone else at Eremea regarding this complaint? *
NoYes

Further details about who you have discussed this complaint with

What does your complaint relate to

Complaint Details
Physical environmentPersonal propertyMedication managementHealth and personal careFood and cateringAbuseConsultation and communicationChoice and dignityFalls and falls preventionPersonnel and staff conductSecurity of tenureFinancialOther

Provide specific details about your physical environment concern here

Provide specific details about your personal property concern here

Provide specific details about your medication management concern here

Provide specific details about your health and personal care concern here

Provide specific details about your food and catering concern here

Provide specific details about your abuse concern here

Provide specific details about your consultation and communication concern here

Provide specific details about your choice and dignity concern here

Provide specific details about your falls and falls prevention concern here

Provide specific details about your personnel and staff conduct concern here

Provide specific details about your security of tenure concern here

Provide specific details about your financial concern here

Provide specific details about your other concern here

You can optionally upload up to 4 related files here

Please select up to 4 files (Files can be of type doc, docx, xls, txt, pdf or jpg) and have a maximum size of 10MB in total for all the files.

Complaint resolution

Would you like to be involved in the resolution process?
NoYes

What outcome would you like from this complaint?

Would you like to be updated on the resolution investigation?
NoYes

Would you like feedback on the resolution of this complaint?
NoYes

You are about to submit this complaint form to Eremea Home Care Services. If the matter you are raising involves a serious issue affecting the safety, health or wellbeing of a person receiving aged care, or if it relates to the commission of a serious offence, we may be obliged to refer relevant material to the appropriate external agency, including appropriate health professional regulatory bodies and the police.