Below is a sample of the emails you can expect to receive when signed up to aacqa.
Your online complaints form has been received by the Aged Care Quality and Safety Commission. The details of your complaint are below.
Your temporary reference number is: 202004210602090001
Received on: 21/04/2020 6:02:09
A complaints officer will contact you about your complaint within 2 business days during business hours (unless you are anonymous). They will explain the complaints process, clarify any matters you have raised and answer any questions you might have.
If you wish to speak to a complaints officer , you are welcome to call us on freecall 1800 951 822.
If you have made a complaint and not heard from us within 2 business days, please call us on 1800 951 822.
Thanks for contacting us.
| Data Name | Data Type | Options |
|---|---|---|
| Please click on the check box below to confirm that you have reviewed the Notice of Collection that explains how we use personal information. |  Text Box | |
| First name | Text Box | |
| Last name | Text Box | |
| Title | Text Box | |
| Password | Text Box | |
| Text Box | ||
| Home address | Text Box | |
| City | Text Box | |
| State | Text Box | |
| Postcode | Text Box | |
 checklist | Please click on the check box below to confirm that you have reviewed the Notice of Collection that explains how we use personal information. | |
 dropdown | -- Please select your title -- | |
| dropdown | -- Please select your title -- | |
 number | ||
| dropdown | -- Please select your title -- | |
| dropdown | -- Please select your title -- | |
| dropdown | -- Please select your title -- | |
 option | Complainant information My complaint relates to: * | |
| option | The care or services I am receiving | |
| option | Is the person receiving care aware of this complaint? | |
| option | Yes | |
| option | No Does the person receiving care consent to this complaint being raised? | |
| option | Yes | |
| option | No Are you authorised to make decisioons on behalf of the person receiving care? | |
| option | Yes | |
| option | No If you have a copy of the instrument or order which authorises you to make decisions on behalf of the care recipient Please upload it in the file upload section further down on this page. Details of your complaint Complaints can relate to care, catering, financial matters, hygiene, equipment, security, activities, choice, comfort and safety or other matters related to the responsibilities of an service pro | |
| option | Yes | |
| option | No Have you contacted anyone else regarding this complaint? * | |
| option | Yes | |
| checklist | What does your complaint relate to Complaint Details: | |
| checklist | ||
| checklist | ||
| checklist | ||
| checklist | ||
| checklist | ||
| checklist | ||
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| checklist | ||
| checklist | ||
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| checklist | ||
 file | ||
| file | ||
| file | ||
| file | ||
| file | ||
| dropdown | -- Please select your title -- | |
| dropdown | -- Please select your title -- | |
| option | Complaint resolution Would you like to be involved in the resolution process? | |
| option | Yes | |
| option | Would you like feedback on the resolution of this complaint? | |
| option | Yes |
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