Carinity Customer Complaints, Compliments and Feedback Form "*" indicates required fields Step 1 of 4 0% Submit your Feedback to Carinity Thank you for taking the time to contact us. If your feedback involves concerns about serious misconduct or breaches of legislation, you should report this through our Carinity Speak Up Whistleblower Hotline. Otherwise, please select from one of the options below so we can handle your feedback in the most appropriate manner. What best describes your comments* 😐 Feedback 😞 Complaint 🙂 Compliment Please describe your relationship to Carinity* Family Member Legal Representative Resident Client Staff Visitor Volunteer Contractor Supplier Other Prefer not to say Which Carinity service does your feedback relate to* Residential Aged Care Home Care Retirement Living Youth & Communities Carinity CHSP Disability Services Carinity Head Office Other Location Facility* Brookfield Retirement Brownesholme Retirement Elim Estate Retirement Kepnock Grove Retirement Shalom Retirement Fairfield Grange Retirement Wishart Gardens Retirement Other Location / Facility* Bribie Island Brisbane North Brisbane South Wide Bay Fraser Coast West Moreton Fitzroy South Coast Logan River Valley Sunshine Coast Toowoomba Townsville Other Location / Facility* Brookfield Green Brownesholme Cedarbrook Clifford House Colthup Manor Fairfield Grange Hilltop Karinya Place Kepnock Grove Shalom Wishart Gardens Other Location /Facility* Other Location / Facility* Bunderra Our House Other Location / Facility* Fassifern Community Illoura Narangba On Track Orana Talera Wahroonga Other Location / Facility* Gaythorne Other About YouPerson Submitting This Formremain anonymous I prefer to remain anonymous Your Name* First Last How Can We Reach You?Please provide your details below so we can communicate with you as per your preferencesPreferred Method of ContactEmailPhoneYour Email Address* Email Address Confirm Email Address Your Phone*Best Time to Call You*Select A Time12:00 am12:30 am1:00 am1:30 am2:00 am2:30 am3:00 am3:30 am4:00 am4:30 am5:00 am5:30 am6:00 am6:30 am7:00 am7:30 am8:00 am8:30 am9:00 am9:30 am10:00 am10:30 am11:00 am11:30 am12:00 pm12:30 pm1:00 pm1:30 pm2:00 pm2:30 pm3:00 pm3:30 pm4:00 pm4:30 pm5:00 pm5:30 pm6:00 pm6:30 pm7:00 pm7:30 pm8:00 pm8:30 pm9:00 pm9:30 pm10:00 pm10:30 pm11:00 pm11:30 pmContact details not requiredYou have opted to remain anonymous, no contact details are required to be entered. Please take note of the reference number when submitting this form if you would like to contact us later and track the handling of your feedback. 😐 Feedback DetailsPlease provide details in the space below to describe the topic you would like to bring to our attention.😞 Complaint DetailsPlease provide details in the space below to describe the topic you would like to bring to our attention.🙂 Compliment DetailsPlease provide details in the space below to describe the topic you would like to bring to our attention.Your Comments/Questions*Are you submitting this feedback on behalf of someone else? Yes No Person Affected*Please provide the details of the person who experienced or is affected by this issue (e.g., your family member). This is not the staff member involved. First Name Last Name Do your comments relate to a staff member or individual Yes No Person Your Feedback Is About*If your comments are related to a specific person, please provide their Name and/or Role if known. First Name Last Name Role Distinguishing HR Grievances from Service Complaints*Based on your selections, this may fall under an HR grievance. Please tick the box below to confirm that this is not an HR issue. If it is an internal HR matter, please stop completing this form and contact HR directly. I confirm that this submission does not relate to an internal HR issue and is appropriate for this form. Distinguishing HR Grievances from Service Complaints*Based on your selections, this may fall under an HR grievance. Please tick the box below to confirm that this is not an HR issue. If it is an internal HR matter, please stop completing this form and contact HR directly. I confirm that this submission does not relate to an internal HR issue and is appropriate for this form. Privacy handling Based on the information you have provided, your feedback/complaint will be flagged as sensitive, and will not be accessible to all staff. Our senior leadership team will receive and assess your feedback/complaint and determine whether it can be addressed by our onsite teams or whether it needs to remain available only to senior leaders. Help Us Further Understand Your FeedbackWe use this short survey to understand how significant the issue is from your perspective. Your responses help determine the level of attention required. Please answer honestly so we can prioritise your feedback correctly.Skip Survey opt out of survey Following the matter you are providing feedback about, how do you feel about the service provided by Carinity* Very Satisfied Satisfied Neutral Unsatisfied Very Unsatisfied How important is the topic you are highlighting* Very Important Important Somewhat Important Not Important Would you be more or less likely to recommend Carinity to family or friends as a result of the matter you are providing feedback about?* A lot less likely A little less likely Not Sure A little more likely A lot more likely Based on previous experiences with Carinity, how has this most recent event changed how you feel about Carinity* Much Better Somewhat Better About the Same Somewhat Worse Much Worse For more information about next steps and how we handle your feedback, you can access a copy of our Feedback and Complaints policy and a copy of our Privacy Policy. Δ
