Have you previously started a form?
Complaint Reference Number:
Please resolve the following issues before proceeding
Click on an issue to go directly to the related section of the form.
errors found:
warnings found:

Submission Received

Complaint Contact Form
We have received your complaint. We will contact you to discuss your complaint - but if you do not feel safe, please call 1800 035 544 so we can help you more quickly. If you or someone you know is in crisis, call 000 or Lifeline on 13 11 140

Next steps

You are required to complete these additional forms to finalize your request.
Your Complaint Reference Number is:
Please quote your Complaint Reference Number when enquiring about your submission.

For your records

Would like a copy of this submission for your personal records?
OR

Check your email

We've sent a copy of your submission to your email address ().If you didn't receive it or would like another copy, just select one of the options below.
OR

Form Saved

Complaint Contact Form
Your form has been saved and may be re-opened later.
Your Complaint Reference Number is:
Please note that your saved form, if not updated or submitted within a set period of time, will be deleted.Please ‘Send yourself a reminder email’ below. This email details the date and time your form will be deleted, the Tracking Code number, a link to access your saved form and information on how to contact us for further assistance.

Send yourself a reminder email

Enter your email address and we'll send you instructions on how to return to your form.

Check your email

We've sent instructions to your email address () on how to return to the application when you are ready. If you didn't receive it or would like a reminder send to a different email address, just click the link below and follow the instructions.

Complaint Contact Form

Complaint Contact Form
Fields marked with * are required

Make a complaint

If you have a concern about your current NDIS supports or services, it's important to talk about it. Anyone receiving NDIS supports or services in any state or territory, except Western Australia, can make a complaint about an NDIS Provider.Existing arrangements for making complaints in Western Australia remain in place until 1 December 2020. Visit our website if you wish you make a complaint about an NDIS Provider in Western Australia (opens a new window).If you want to make a complaint about your NDIS plan or planning process, in any state or territory, please contact the National Disability Insurance Agency (opens a new window).Your family or friends can talk to us on your behalf. Our service is completely free and independent.We will need to know who is involved, what you are not happy about, what you want to happen, and some information about you. With this information, we will work with you and your NDIS provider to resolve your complaint.We recommend that you call our complaints line directly on 1800 035 544. Even if you’re not sure yet if you want to make a complaint, we can provide advice and information to help you decide what you want to do.There are many ways to make a complaint to the NDIS Quality and Safeguards Commission:•Call us on 1800 035 544•Fill out the complaint contact form below and we will contact you•Use TTY on 133 677•Use National Relay Service (opens a new window) and ask for 1800 035 544•Use an interpreter.

Please provide your details:

If you wish to make a confidential or anonymous complaint, it is better if you call our contact centre on 1800 035 544 and ask to speak to our complaints team.
When can we contact you?

Are you making this complaint on behalf of a person with disability? *

Please provide details of the person with disability:

Do you require any help with communication? e.g Interpreter or National Relay Service?

Do you require any help with communication? e.g Interpreter or National Relay Service?

Please provide details of this NDIS provider:

Visit our website if you wish to make a complaint about an NDIS Provider in Western Australia (opens a new window).

Tell us about your complaint

/1000 characters
/1000
Have you spoken to your provider?