Client Complaint Form

Name: Postal Address: Residential Address: Telephone Business Hours: After Hours: Details of complaint I request that you review my complaint: (Please attach any/all relevant information)

Print Form

What would be your preferred outcome?
(Must be completed)

Client's Signature: OFFICE USE ONLY Initial Contact Officers Name: Pathways Request Number: Has the complaint been resolved?
(Details of action taken must be attached)


Date Received:

Dataworks Number: YES / NO

· relates to the actions or conduct of private individual. or · the lodging of an appeal in accordance with a procedure or policy. Latrobe City Council. · relates to conduct before a court. · relates to the appointment or dismissal of any employee or an industrial or disciplinary issue. Dissatisfaction may arise from the service provided by Council staff. · a request for information. · relates to a matter awaiting determination by the Council. Noise complaint). · reports concerning neighbours or neighbouring property (eg. The City may disclose some of this information to relevant organisations if the nature of the complaint involves services delivered/matters dealt with by parties other than Requests for access and or correction should be made in writing addressed to the Privacy Officer. Morwell VIC 3844 Phone: Fax: Web: Email: Disclaimer The personal information requested on this form is primarily being collected by the City for the purpose of investigation and responding to a complaint. 1300 367 700 (03) 5128 5672 www. whether or not the complainant uses that remedy or right of appeal. Where do I send my complaint? Please address all correspondence to: Chief Executive Officer Latrobe City Council PO Box 264 Morwell 3840 Questions? Latrobe City Council 141 Commercial Road. If sufficient information is not collected on this form.vic. · reports of hazard (fallen trees). Where the Chief Executive Officer determines that a complaint will not be investigates. What is not considered to be a complaint? A complaint does not include: · a request for . · relates to a matter under investigation by the Minister for Local Government or any other government department including the Victorian Police Service. Uneven footpath). · there is insufficient information the complainant will be advised accordingly in writing. · reports of damage or faulty infrastructure (eg. councillors. The submitter understands that the personal information provided is to assist in the resolution of a complaint and that he or she may apply to Latrobe City Council for access to and/or amendment of the information. policies or procedures. · relates to a decision of Council. documentation or explanation of policies or procedures or decisions of council. contractors and systems or from the impact of a particular policy or procedure. This information will be used solely by the City for that purpose or directly related purposes. Complaints that will not be investigated The Chief Executive Officer may determine that a complaint will not be investigated where: · the matter is considered frivolous.vic. Latrobe City Council may not be able to effectively address the issue(s) raised and provide feedback to the submitter. or · the complainant declines or refuses to provide further information or where there are threats made against Council or council staff. vexatious or not made in good latrobe@latrobe.Client Complaint Form What is a complaint? A complaint is an expression of dissatisfaction with Council's level and quality of service. · involves a matter where an adequate remedy or right of appeal already exists. coroner or

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