Thank you for submitting this information. An advocate will be in contact with you.
This form is designed to help you make a complaint to the Nationwide Health and Disability Advocacy Service about a health or disability service provided to you.
The Advocacy Service is a free service that operates independently from all health and disability service providers, government agencies and HDC. Advocates will support or guide you to express and try to resolve your concerns directly with the provider of the service in the first instance.
After you submit this form an advocate will contact you by phone to discuss your concerns and how you would like to resolve them.
If you have any questions or would like assistance with filling in this form you can contact an advocate on Free Phone: 0800 555 050.
Contact details (please note we are unable to text you)
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