Client Feedback Form - QLD

This form is for you to give Therapy Pro feedback, about our staff, services or the organisation. It can be used to:

1. provide a compliment
2. make a complaint,
3. suggest service improvements

We record all feedback received in our feedback register. This is used to help Therapy Pro improve our organisation and maintain our commitment to providing quality therapy that makes a difference. We are committed to an outstanding client experience and excellent services to ensure you realise your goals.

You do not have to provide your personal details, but if you do this information will be kept confidential.

Therapy Pro encourages you to provide feedback in writing. We will respond to you within ten (10) working days if you provide your details.

This online form will be sent to the General Manager at info@therapypro.com.au.

If you would prefer to provide feedback verbally you can speak to any Therapy Pro staff member of your choice, either at your next appointment or by contacting Therapy Pro on 1300 004 414.

If you are not sure about something, or would like help to complete this form, you can speak to any Therapy Pro staff member.

Details of the Feedback

Is this ...

a compliment?
a complaint?
a suggestion for service improvements?

Is this about ...

a Therapy Pro staff member?
the services you received?
a specific issue?

Would you like Therapy Pro to contact you to discuss the feedback on this form?

Yes
No

Your details

If you would like Therapy Pro to contact you in regard to your feedback, please provide your details here. To help us respond to your feedback quickly, let us know if your contact details change.

Name

Title First Last

Postal Address

Street Address City State Postcode

Your email

Phone Number

Mobile

Have you given Therapy Pro feedback before?

No
Yes, and the matter was resolved
Yes, but the matter was not resolved

Please provide brief information/comment about that matter

Is there anyone else (legal representative, advocate or support person) that you would like to be involved in providing this feedback to Therapy Pro?

No
Yes

If yes, please provide their name

First Last

Postal Address

Street Address City State Postcode

Phone

Representative email

If you want to attach any extra information, or any documents that may help us to handle a complaint, grievance or a concern (eg if you have letters, emails or faxes or records of conversations you have had with the person/s associated with the complaint), please attach copies (not the original).

Feedback that is a Compliment or Complaint

What happened?

Where did it happen?

When did it happen? (Include date if possible)

Who was involved? (Name any persons involved and if relevant, details of witnesses)

Is there anything else you want to tell us?

If this is about a Therapy Pro staff member or the service they provided you, have you discussed this with them?

Yes
No

How did the Therapy Pro staff tell you they would respond?

Is there any reason/s that you are not able to speak to Therapy Pro staff directly (eg for safety reasons, for cultural reasons)?

What action would you like Therapy Pro to take?

If you think that the issue you have raised with Therapy Pro cannot be resolved, you may want to seek support from the relevant state government department in Queensland, as follows: During Queensland’s transition to the National Disability Insurance Scheme (NDIS) people with disability who are participants of NDIS can raise issues that they have with Therapy Pro with the Department of Communities, Child Safety and Disability Services. More information can found online at www.communities.qld.gov.au/gateway/about-us/compliments-and-complaintsfeedback or by emailing feedback@communities.qld.gov.au

Participants of the National Disability Insurance Scheme (NDIS) can raise issues about Therapy Pro via the NDIS Quality & Safeguards Commission 1. www.ndiscommission.gov.au/about/complaints 2. Phone 1800 035 544 (free call from landlines) or TTY 133 677. Interpreters can be arranged. 3. Phone National Relay Service and ask for 1800 035 544.

Feedback that is a Suggestion for Service Improvement

Can you tell us what areas Therapy Pro needs to improve? (Tick one or more boxes)

Quality of client service delivery received
Quality and effectiveness of the therapy received
Overall management and operations
Meeting cultural needs
Handling complaints/concerns or grievances
Safety and wellbeing
General enquires and information

What do you suggest we can do to improve in these areas?

How do you feel about the staff at Therapy Pro?

Therapy Pro staff’s ability to do their job?

Very competent
Competent
Not competent

Therapy Pro staff’s client service skills?

Excellent
Good
Poor

What areas do you think Therapy Pro could improve in to meet your needs? (Tick one or more boxes)

Expertise/experience
Cultural knowledge and skills
Communication and listening skills
Providing you information about our services and what happens next
Making sure you are involved in decisions about you
Maintaining privacy and confidentiality
Behaviour and attitude
Getting things done on time
Working with other organisations or services to help you meet your needs

If something is not listed above, please provide us some detail here:

What do you suggest we can do to improve staff in these areas?

Thank you for your feedback. We aim to resolve or address any matters you have raised within 10 working days. For more information,or if you need to speak to us, contact us at Therapy Pro on 1300 004 414 or by email to info@therapypro.com.au.

Contact Us

Client Feedback Form - QLD

Details of the Feedback

Your details

Feedback that is a Compliment or Complaint

Feedback that is a Suggestion for Service Improvement

How do you feel about the staff at Therapy Pro?

Learn More

Contact Us

Client Feedback Form - QLD

Details of the Feedback

Your details

Feedback that is a Compliment or Complaint

Feedback that is a Suggestion for Service Improvement

How do you feel about the staff at Therapy Pro?

Stay in touch

Learn More