Complaint and Grievance Form
About the Complaint and Grievance Form
A digital complaint and grievance form that allows parents, guardians, and community members to formally lodge complaints or concerns with the education and care service. Under Regulation 168(2)(o), services must have policies and procedures for dealing with complaints. This form captures contact details, a description of the complaint, desired outcomes, previous communication history, and supporting documents.
Also called
- Complaint form
- Grievance form
- Parent complaint form
- Feedback and complaints form
What's on this form
Every question included in the complaint and grievance form. Add, remove or reword any of them in the form builder.
Form questions
Your Full Name
Short answer
Your Email Address
Email
Your Mobile Number
Mobile
Your Relationship to the Service
Short answer
Complaint Details
Date of Incident or Concern
Date
Description of Complaint or Concern
Long answer
What outcome are you seeking?
Long answer
Have you previously raised this concern with the service?
Yes / No
Details of previous communication
Long answer
Supporting Information
Declaration
Declaration
I confirm the information provided is true and accurate to the best of my knowledge.
Signature
Signature
Australian regulations this form supports
The complaint and grievance form is built around the Education and Care Services National Regulations. These are the regulations it helps you meet.
Policies and procedures — dealing with complaints
The service must have policies and procedures in relation to dealing with complaints.
Read the full text of Reg 168(2)(o)
The approved provider of an education and care service must ensure that the service has policies and procedures in relation to dealing with complaints, including matters relating to— (i) the provision of a complaint handling system at the service that is child focused; and (ii) the management of a complaint that alleges a child is exhibiting harmful sexual behaviours.
Time to notify certain information to Regulatory Authority
The approved provider must notify the regulatory authority within specified timeframes of certain complaints alleging a breach of the National Law or that the safety, health or wellbeing of a child was or is being compromised.
Read the full text of Reg 176
(1) For the purposes of section 174(3) of the Law, a notice must be provided within 7 days of the relevant event or within 7 days of the approved provider becoming aware of the relevant information. (2) For the purposes of section 174(4) of the Law, a notice must be provided— (a) in the case of a notice under section 174(2)(a)— (i) in the case of the death of a child, as soon as practicable but within 24 hours of the death, or the time that the person becomes aware of the death; and (ii) in the case of any other serious incident, within 24 hours of the incident or the time that the person becomes aware of the incident; (b) in case of a notice under section 174(2)(b) or a notice of a matter referred to in regulation 175(2)(b), within 24 hours of the complaint or incident; (ba) in the case of a notice under regulation 175(2)(ca), within 24 hours of the commencement of the attendance of the child or children at the education and care service; (bb) in the case of a notice under regulation 175(2)(d), within 24 hours of the incident or within 24 hours of the approved provider becoming aware of the incident; (bc) in the case of a notice under regulation 175(2)(e), within 24 hours of the allegation being made or within 24 hours of the approved provider becoming aware of the allegation; (c) in any other case, within 7 days of the relevant event or within 7 days of the approved provider becoming aware of the relevant information.
Provided for information only and may not reflect the latest amendments. Refer to the Education and Care Services National Regulations (NSW) for the official legal text.
Where this form fits
The complaint and grievance form is part of these jobs — each guide walks through the whole sequence and the other forms that go with it.
Questions about the complaint and grievance form
What is the complaint and grievance form used for?
A digital complaint and grievance form that allows parents, guardians, and community members to formally lodge complaints or concerns with the education and care service. Under Regulation 168(2)(o), services must have policies and procedures for dealing with complaints. This form captures contact details, a description of the complaint, desired outcomes, previous communication history, and supporting documents.
Who fills in the complaint and grievance form?
The complaint and grievance form is completed by a parent or guardian. You send them a secure link by email or SMS — they don't need an account, an app, or a password to fill it in and sign.
Which Australian regulations does the complaint and grievance form meet?
It is built around Reg 168(2)(o) and Reg 176 of the Education and Care Services National Regulations. Reg 168(2)(o) covers policies and procedures — dealing with complaints. Reg 176 covers time to notify certain information to regulatory authority. Every question the regulations require is already on the form.
Is the complaint and grievance form the same as a complaint form?
Yes. Different services use different names for this form — it is also called complaint form, grievance form, parent complaint form and feedback and complaints form. They all describe the same record, and this template covers it. You can rename it to whatever your service already calls it.
Can I change the questions on the complaint and grievance form?
Yes. The template comes with 14 fields ready to go, but you can add, remove, reword or reorder anything in the drag-and-drop form builder, and add your own conditional logic and signing steps. Your changes only affect your service's copy.
Is the complaint and grievance form free?
Yes — the complaint and grievance form is free to use on the Childcare Forms free plan. No credit card is required to create an account and start sending it.
Ready to use it?
Create a free account, change anything you want, and send it to your first family. No credit card needed.