Feedback Form We value your feedback We want to hear about your experience with our services, programs, events, staff, volunteers, contractors and partnerships. Your feedback helps us improve what we do. You can use this form to: Give a compliment Make a suggestion Raise a concern Make a complaint Report something that made you feel unsafe You can provide feedback anonymously if you wish. If your concern is in relation to an emergency, please call 000 immediately. Your FeedbackWhat types of feedback would you like to provide? Compliment Suggestion Concern Complaint Incident Child or young person safety concern Other What is your feedback about? A program or project HCT offers An event or workshop Staff Member Volunteer Contractor or consultant Better Health 4 Dorset Hub Website or online Other About Your FeedbackPlease tell us what happened or what feedback you would like to provideWhen did this occur? Where did this occur?EventOnline meetingBH4D HubPhone callEmailOtherIf you are raising a concern, is it in relation to a serious incident or a concern about the wellbeing or safety of a child? Yes No Please phone Ellen MacDonald, CEO on 0493 960 818 or contact the HCT Office on (03) 6210 2800. Outcome SoughtWhat would you like to happen as a result of your feedback?For example – you might have just wanted to let us know, follow up discussion, formal response, issue resolved or something else.About youWould you like us to contact you about your feedback? Yes No Name First Last Email PhoneOrganisation (if applicable)
