ACON Complaint Registration Form

All complaints are confidential and will only be discussed with the person(s) involved.

All complaints are taken seriously.
Name

First NameLast Name
Email Address

Confirmation EmailPlease confirm your email address
Contact Number
Format: 0000 000 000.
Preferred time to be phoned
Address

Street Address

Street Address Line 2

SuburbState

PostcodeCountry
Details of Complaint
Date & Time

DayMonthYear
When did the incident happen
Hour MinutesAM/PM Option
Location
Where did the incident happen?
Parties involved
Who was involved in the incident?
Type of Complaint

Other:
Description of the incident:

(Max. 700 words)0/700
What will happen now?

Once your complaint has been received, the following steps will be taken:
1. ACON will create a confidential file for your complaint in the Complaints Register.
2. ACON will acknowledge receipt of your complaint (if you have included your name and contact details).
3. The CEO will either investigate the complaint directly or delegate this task to someone else, e.g. Manager of the relevant area.
4. Your complaint will be investigated (all parties named in the complaint will be consulted) and ACON will respond to you as quickly as possible.
Verification
Should be Empty:

Details of Complaint