Feedback and Complaints

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Feedback and Complaints

We value your input and welcome you to share your feedback. Feel free to complete the form below or reach out to us at 0800 115 477.
Alternatively, you can provide anonymous feedback or disclose your information by completing this form.

Read our full complaint-handling process here

Feedback and Authority to Disclose Information Form

Our Feedback and Authority to Disclose Information Form allows you to provide feedback while granting us permission to disclose relevant information for prompt resolution and improvement.

First Name(s)

Last Name

Preferred Name

Contact Number

Email Address

Name of your employer

Name of Professional or person who provided the service (if applicable)

What type of appointment did you have?

In person Telephone/Video E-counselling/other

EAP Services reference number (if available)

Date of appointment

Describe in detail the nature of your feedback, including all individuals involved

I consent that my feedback and related communications may be disclosed to the following people:

Name

Relationship to client (e.g. line manager)

Phone

Name

Relationship to client (e.g. line manager)

Phone

Name

Relationship to client (e.g. line manager)

Phone

Personal Statement

I understand information in this form will be reviewed by the EAP Services team and may be made available to the person(s) listed above to investigate and reach an outcome.

I declare that the above information is true and correct.

Feedback and Complaints

Feedback and Complaints

Feedback and Authority to Disclose Information Form

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