Complaints/Feedback about the Office of the Disability Services Commissioner (DSC)

Making a complaint/Providing feedback

Please complete the form below to submit your complaint/feedback. Complaints/Feedback about theDSC can be made in any form (for example, in person, by telephone, facsimile, email or in writingusing this form). You must provide the DSC with your name and a postal address for correspondence, as well as a phone number if possible. We cannot conduct a formal review of a complaint without this information.

Complaint handling process

  1. Complaints will be brought to the attention of the Internal Complaints Assessment Officer, who will determine the person best placed to assess the issues raised in the complaint.
  1. The Internal Complaints Assessment Officer will then refer the matter to the appropriate Principal Officer, where necessary.
  1. Complainants are kept informed of the progress of their complaint throughout the process.
  1. At the completion of the assessment of the matter, the Internal Complaints Assessment Officer will provide the complainant with a written response advising of the outcome.

Information privacy –

The information you provide in this form may be used by the Internal Complaints Assessment Officer to assess your complaint/feedback.

1. Please provide your name and contact details.

First Name:Last Name:

Address:

Suburb:State:

Phone Number:TTY:

Email:

2. Are you making acomplaint on behalf of someone else?

Yes NoGo to question 5

If yes:

what is your relationship to the person (eg. parent, advocacy support worker, carer etc)?

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

YesNo

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

First Name:Last Name:

Address:

Suburb:State:

Phone Number:TTY:

Email:

  1. Description of your complaint/feedback - Is this about:

A DSC ProcessYes No

if yes, please refer to question 5.1 below

Conduct of DSC StaffYes No

if yes, please refer to question 5.2 below

A decision made by the DSCYes No 

if yes, please refer to question 5.4 below

- Please note: Such decisions include decisions to consider or decline to consider a complaint, to refer a complaint to conciliation or investigation, and decisions to stop dealing with a complaint. The Disability Act 2006 does not provide for the review or appeals of decisions made by the Commissioner or his delegate. Complaints however can be received about the explanations provided for a decision made by the Commissioner or his delegate.

5.1 Is the issue being raised as feedback for the office, or is it a matter for which you are seeking a specific resolution?

FeedbackOutcome

5.2 If your complaint relates to a DSC process, please answer the following:

a) What process/es are you dissatisfied with? (Describe in detail the specificissue/s or event/s that are the basis of your complaint, and provide details where possible)

5.3 If your complaint relates to a DSC staff member, please answer the following:

a) What is the staff member’s name?

b) On what date/s did the issue/s or event/s occur?

c) What did the staff member do that you wish to complain about?(Describe in detail the specific issue/s or event/s that are the basis of your complaint, and provide details where possible)

5.4If your complaint relates to a decision made by the Commissioner or his delegate, please answer the following:

a)What is the decision you are complaining about?

b) In relation to the explanation provided for this decision, what are you dissatisfied with?

6. What outcome/s are you seeking?

  1. If you are providing general feedback, what do you wish to tell us?

Attachments

If you have documents that can help us you can attach them to your complaint. Please list below all additional documents that you will be providing:

Privacy Statement

The DSC is bound by laws that protect your privacy concerning the collection, use and disclosure of your personal information. You can request access to your personal information by contacting us.

Signature: ______Date:___/___/___

Print name: ______

What to do next-

Send this completed form to:

Internal Complaints Assessment Officer

Disability Services Commissioner

Level 30/570 Bourke Street

Melbourne Vic 3000

Phone: 1300 728 187Fax: 03 8608 5765

(Note: Faxes cannot send double sided documents)

TTY: 1300 726 563Website:

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