Is the feedback on behalf of someone else?
*
Yes
No
Full name
*
First Name
Last Name
Client reference number (if known)
Back
Next
Has this matter been raised before?
*
Yes
No
Back
Next
The issue/Feedback
Feedback type
*
Complaint
Compliment
Enquiry
Suggestion
Other
Feedback relates to:
*
Access to Services
Communication
Cost
Decision Making
Delivery of Services
Disability Access
Legal
Products (eg brochures, websites)
Staff
Other
Feedback method
*
Please Select
Online Internet Form
Email
Fax
Paper Form
In Person
Letter
Phone
What outcome do you want?
*
0/200
What happened and who was involved?
*
0/400
File upload (if any)
Browse Files
Drag and drop files here
Choose a file
Supporting documents - maximum 2MB. Only pdf, docx, xlsx, jpg, jpeg, png file types allowed.
Cancel
of
Back
Next
Your preferred response from the Public Trustee
*
Email
Letter
Name
*
Mr
Mrs
Ms
Mx
Miss
Master
Dr
Professor
Prefix
First Name
Last Name
Address
*
Email
example@example.com
Phone Number
-
Area Code
Landline, Mobile or Work Phone Number
Back
Next
Are you under 18 years old?
*
No
Yes
Date of Birth
*
/
Day
/
Month
Year
Date Picker Icon
You must be under 18 years old
Do you identify as Aboriginal or Torres Strait Islander?
Yes
No
Prefer not to say
Do you identify as a person with disability?
Yes
No
Prefer not to say
Do you require an interpreter or any other assistance with your feedback? (ie large font, TTY)
Yes
No
Back
Next
Acknowledgement
Declaration - I authorise the Public Trustee to:
*
discuss my feedback with the relevant service provider/program within the Public Trustee.
request and collect any relevant information or documents about me relating to this online form from any other organisation which may be involved with this feedback.
Please verify that you are human
*
Sender
Submission date and time
*
/
Day
/
Month
Year
Date Picker Icon
Hour Minutes
AM
PM
AM/PM Option
Closed date and time
*
/
Day
/
Month
Year
Date Picker Icon
Hour Minutes
AM
PM
AM/PM Option
Number of days
Submit
Should be Empty: