You can submit your feedback using this online form. Read about other options and the complaints process on the patient complaints and compliments page, or contact the complaints coordinator on (08) 8999 2572 or email@example.com
If your complaint relates to a breach of information or privacy, please use our Privacy Complaint Online Form instead.
Required fields are marked with an asterisk (*).
Type of feedbackComplaintComplimentEnquirySuggestion
Who is providing the feedbackPatientFamily memberCarerOther
If you are providing feedback on someone else’s behalf, have you received consent to do so?YesNoNA
Please note we are required to confirm consent directly with the patient and contact will be made once the feedback is received.
Date of birth (if you are the patient)
If you are providing the feedback on behalf of someone else, provide the patient’s details below:
Patient - First name
Patient - Last name
Patient - Phone number
Patient - Email address
Patient - Date of birth (so we can look at your file)
Please select the service you are providing feedback about.
The region where you accessed the service:
In case of a hospital service:Please selectAlice Springs HospitalGove District HospitalKatherine HospitalPalmerston Regional HospitalRoyal Darwin HospitalTennant Creek Hospital
In case of non-hospital services:Please selectAged careAlcohol and other drugsCancer screeningChildren's developmentClinic 34COVID-19 testingCommunity health clinicEnvironmental healthHearingImmunsationMental healthOral healthPrison health and police watch houseTerritory Equipment Program and Seating Equipment and Technical Service (TEP and SEAT)Tuberculosis or leprosy clinicOther
What date (approximately) did you access the service?
Provide a brief summary of your feedback (up to 250 words) *
Last updated: 01 November 2016
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