Elizabeth Eye Care welcomes feedback from patients, their families or their
carers about the quality of care that is provided within our optometry clinics.

Patient feedback is important to us. It helps us to identify ways in which we can improve our services to the community. Patients and their families are encouraged to provide suggestions, compliments, concerns and complaints and there are a number of ways this can occur.

Name of person providing feedback (optional)

Type of feedback (please tick)

General feedbackComplimentComplaint

Details of feedback

Date of service or activity (if known)

If you have a complaint, do you want to be contacted further about this?
YesNo

Are you a (please tick)
PatientCarer / RelativeCommunity memberAgency

What happens next?
Compliments and suggestion will be forwarded to the relevant staff members. If your feedback is
a complaint and you have nominated to be contacted, you will receive a response from the
Australian College of Optometry within 4 to 6 weeks. The information contained on this form will be kept confidential. The personal information will not be used for anything other than the specific purpose for which you supply it.

If you are not satisfied with the outcome of your complaint to the ACO, it is your right to make a complaint to the Health Complaints Commissioner. The Commissioner is an independent statutory authority established to receive complaints regarding health service providers in Victoria. For further details contact 1300 582 113 or visit https://www.hcc.vic.gov.au In South Australia, complaints should be directed to the Health and Community Services Complaints Commissioner https://www.hcscc.sa.gov.au