Complaints and Feedback Form Fill in the details of the person who is making the complaint/ providing feedback. Name of Person: Address*: Phone: Email: My preferred contact method is*: If you are making the complaint/feedback on behalf of another person provide the following details. Your Name: What is your relationship to the person?: Does the person know you are making this complaint/providing feedback?: Does the person consent to the complaint/feedback being made?: Who is the person, or the service about whom you are complaining or providing feedback about? Name*: Contact Details (if known): What is your Complaint/Feedback about? Provide some details to help us understand your concerns. You should include what happened, where it happened, time it happened and who was involved*: What outcomes are you seeking as a result of the complaint/feedback?*: By submitting this form, you acknowledge that the information you provide will be used by Rivergum Support to respond to your enquiry. Please review our Privacy Policy and Terms & Conditions to understand how your information is handled.
