Feedback Form 2024 - Suggestion I would like to make a suggestion for Nexus Primary Health. It is your right to provide us with feedback, which could be a complaint, suggestion or compliment about the services we provide or the broader organisation – your feedback helps us improve.If you need help to fill out this form or require support to provide feedback please contact us on 1300 77 33 52 or speak to our friendly staff. Question Title * 1. Tell us the date and time that relates to your suggestion. Date / Time Date Question Title * 2. Which service/program/group does your suggestion relate to? Access and Support Alcohol Tobacco and Other Drugs Support Alcohol and Drug Prevention Initiatives Client Journey and Reception Community Health Nursing Continence Nursing Counselling Services Diabetes Education Disability Case Management District Nursing Exercise Physiology Family Violence Support Family Violence Prevention Initiatives Financial Counselling Gay Lesbian Bisexual Transgender or Intersex Community Group Gambler's Help Services General Practitioners Healthy Eating and Food Security Initiatives Horses Helping Humans Home Maintenance Inclusive Practice and Diversity Meals on Wheels Nutrition and Dietetics Occupational Therapy Paediatrician Personal and Home Care Personal Helpers and Mentors (PHaMs) Physiotherapy Podiatry Practice Nursing Respite Social Inclusion Speech Pathology Sunshine Social Group Theraplay The Community Kitchen Transport Assistance Other Other (please specify) Question Title * 3. Where did the event or situation take place? Broadford Office Home GP SuperClinic, Wallan Other offsite Kinglake Seymour Other (please specify) Question Title * 4. Tell us more about the suggestion you are providing today. Provide details here. What would you like to happen as a result of your feedback? Question Title * 5. Would you like a response from us in relation to your suggestion? Yes No Yes No If yes, please provide your full name, telephone number and email address so we can contact you. Thank you Done
