Formal Complaint Form

Name*

Title (Mr, Ms, Mrs, Dr, etc.)First NameLast Name

Preferred name

Business/organisation

Email*

example@example.com

Phone Number*

Address

Street Address

Street Address Line 2

CityState

Post Code

ProductServicePrivacyBehaviour and conduct of DPIRD staff

If name of the staff member is known, please type it here

Title/topic*

Please provide a title/summary of your complaint0/150

Details*

Include Date, time, location and description of the issue0/500

Expected DPIRD Response or Outcome*

What would you like to see in your response from DPIRD0/500

Attachment Upload

Please provide any additional attachments

Have you previously complained to the Department or any other agency regarding this matter? Please provide details below

0/500

Notes

A complaint will be considered invalid if it relates to:

whole-of-government policy
legislation that is outside the direct control of the department
exisint statutory processes with appeal mechanisms
matters that are before the Minister, the Ombudsman of Western Australia or Corruption and Crime Commission
internal staff matters that can be managed under the department's grievance policy

If you do not receive an acknowledgement from DPIRD within 5 working days of lodging your complaint, please contact us on +61 8 6552 2008 or complaint@dpird.wa.gov.au. You will be notified of the outcome of your complaint within 30 working days, however the investigating officer may seek your agreement to extend the timegrame depending on the details provided, complexity and current workload.

Collection notice

DPIRD is committed to protecting your privacy. This notice outlines how we collect, use and disclose your personal information for the purposes of processing your complaint.

1. Collection of personal information

DPIRD is collecting your personal information to properly assess and process your complaint, including your name, contact details, signature and address and any personal information relevant to the matters in your complaint.

2. Requirement to collect information

DPIRD requires this information to investigate and resolve the complaint.

3. Disclosure of personal information

DPIRD may share this information within DPIRD to officers involved in handling your complaint.

4. Consequence of not providing personal information

If you choose not to provide certain personal information, your complaint may not be able to be properly investigated, or process can cause delays, DPIRD may be able to take limited action or decide it cannot proceed with the investigation of your complaint.

Please view DPIRD's privacy statement on our website to find out more about how we collect, use and safeguard personal information.