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Fields marked with an asterisk (*) are required.
Please note, you have 30 minutes to fill out this form.
If you have documents to support your complaint, make sure they are ready to upload. These are not essential, but can help us to assess your complaint. They may include::
Your letter of complaint or email to the health service provider or organisation.
Their response to your complaint
Any other supporting documents such as letters, referrals, photos or invoices.