CLIENT FEEDBACK FORM

Thorne Harbour Health welcomes all kinds of feedback from clients or carers, including complaints, compliments and suggestions. Your feedback will assist us in our regular review of the services that we provide.

What type of feedback are you providing?

ComplaintSuggestionComplimentOther

At least one choice is required. Multiple selections can be made If you are unsure, please select other.

Which THH service, area or function is your feedback in relation to? *

If you are unsure, please select other.

What is the division of the service?

Who is the divisional director?

Please provide the details of your feedbackPlease provide as much detail as you can. The more we know about your feedback, the better we are able to address and act upon your feedback.

PERSONAL DETAILS

Providing your details is optional as anonymous feedback is also welcomed and will be taken seriously.

If you would like Thorne Harbour Health to contact you to discuss your feedback or provide you with an update on how we are addressing it, please provide a name and contact information.

Would you like to provide your name and contact information? *

YesNo

Name *

Please select your preferred method of contact *

PhoneEmail

Please select the poreferred method of contact from the list

Please enter your contact telephone number *

Please enter your contact email address *