Lodge your complaint or appeal

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Phone

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* 5. Which course are you enrolled in?
(Select all that apply)

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* 6. Details of your complaint or appeal

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* 7. What would be your ideal outcome from this process?

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* 8. How could we improve our service or processes to avoid this situation in the future?

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* 9. Privacy statement and declaration
Personal information collected by Breathe Education is protected by the Privacy Act 1998 (the ‘Privacy Act’). Personal information is any information that can be used to identify you and includes sensitive and health information. Breathe Education will only use the information provided on this form to resolve your Complaint and/or Appeal.
We will usually provide the information to other parties within our organisation that may have information relevant to your Complaint/Appeal so that it can be managed fairly.
Your personal information will not be provided to any person your complaint relates to unless it is specifically required to ensure your Complaint and/or Appeal is appropriately dealt with.
None of the information you provide on this form will be disclosed outside the organisation without your permission unless we are required to do so by law.

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