Patient complaint and compliment form

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 consumer engagement, complaints and feedback team on (08) 8999 2579 or feedback.health@nt.gov.au

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 feedback

Who is providing the feedback

Patient - First name

Patient - Last name

Please note we are required to confirm consent directly with the patient and contact will be made once the feedback is received.

If you are providing feedback on someone else’s behalf, have you received consent to do so?

Please advise if you wish to receive a response *

Please select the service you are providing feedback about.

The region where you accessed the service:

In case of a hospital service:

In case of non-hospital services:

What date (approximately) did you access the service?

Provide a brief summary of your feedback (up to 5000 words) *

Upload an attachment or voice memo

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11 March 2025, 6:53 am