Complaint Form

We value your comments and feedback. Your complaints can lead to better services for people with a disability at Alkira, so coming up with solutions together is good for everyone.

If you are making a complaint we will do everything we can to resolve the complaint to your satisfaction.

If you are not satisfied with the way Alkira resolves or handles your complaint the Disability Services Complaints Commissioner can help you. Free Call 1800 677 342 or visit the http://www.odsc.vic.gov.au/

If you need assistance to complete this form, please contact Alkira on 9890 1365 and we arrange for someone to help you.

Clients may like to use an advocate to assist them in presenting their feedback or complaint. Their advocate may be a family member, friend or a representative from an advocacy organisation, such as:

  • Victorian Advocacy League for Individuals with Disability (VALID) (03) 9416 4003
  • Action on Disability in Ethnic Communities 1800 626 078
  • Disability Resources Centre (03) 9481 6646

If you prefer you can download and print this form here and post to:

Alkira Disability Services Ltd
PO Box 200
BOX HILL VIC 3128

Attn: Quality Manager

Phone: (03) 9890 1365

    COMPLAINT FORM

    TELL US ABOUT YOURSELF
    1. Please provide your name and contact details

    First Name (required)

    Last Name (required)

    Your Email (required)

    Your Phone (required)

    Date form completed (required)

    2. Are you making the complaint on behalf of someone else?

    If yes:

    What is your relationship to the person participating in an Alkira service (eg. parent, advocate, support worker, carer etc)?

    3. Does the person know you are making the complaint on their behalf?

    4. If you are making this complaint on someone else’s behalf, please provide their name and contact details:

    First Name

    Last Name

    Email

    Phone

    5. Description of your complaint

    Please provide as much detail as possible including Who, What, Where and When:

    6. What outcome are you seeking?


    7. Privacy Statement

    Alkira is bound by laws that protect your privacy concerning the collection, use and disclosure of personal information. People who participate in our services can request access to their personal information by contacting us.

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    We would love to hear from you!

    For further information about Alkira and related services please contact us below:

    Contact Alkira