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ALACC Health College, Australia requires as much detail as possible about your complaint so that we can address it accurately and thoroughly.

Full Name *

Birth Date *

Day Month Year

Email *

example@example.com

Phone Number *

Current Course undertaking

Complaint is from

Student Staff

Detailed explanation of complaint / appeal (You may wish to attach further documentation)

Attach any relevant documents here ( you can select multiple documents when attaching)

Select File

Please give details of the outcome you are seeking.

Please check the complaints and appeals procedure, so that you can understand the procedure involved with your complaint and/or appeal (If complaint received in person) I agree that all the information provided within is true and correct.

Signature *

Clear

Date *

Day Month Year Hour Minutes AM/PM Option

PRIVACY NOTICE The information provided on this form will be used by ALACC Health College, Australia to follow up your complaint. The information may be provided to ALACC Health College, Australia or staff who is in a position to remedy your complaint; or to the police for law enforcement purposes. The provision of this information is voluntary. It will be stored securely. You may correct any personal information provided at any time by contacting the person to whom you submit this form.

Office Use Only

Complaint received by

Phone Fax In person E-mail

Attach copy of e-mail here

(If complaint received via telephone) I agree I have recorded an accurate description of the complaint / appeal

true

Signature of Staff *

Clear

Staff Name

Click to edit

Day Month Year Hour Minutes AM/PM Option

Complaint Type

Complaint Appeal

Action Taken

Date and briefly state how the Student/or Staff was advised of the outcome

CEO/Director of Studies Signature

Clear

COMPLAINT OUTCOME

Australasian Lawrence Aged Care College has investigated your issue and has based the outcome on all relevant information gathered from various sources. We strive to be fair, equal and unbiased when dealing with any issue. Below we have explained the outcome and reasons/action taken in relation to your complaint / grievance / appeal.

Full Name

Date

Position

Student Staff

Course undertaking

Trainer

Date of your complaint

Date

Brief details of your complaint / appeal

Outcome details including reasons

Complaints / Appeals Form