1300 785 277

Complaints Form

* Mandatory Field

Customer Complaint Form

Complainant Details

Given Name*
Surname (Family)*
Line 1*
Line 2
Line 3
Locality/Suburb
State
Postcode
Daytime Contact Number*
Email

Complaint Details

Date of Incident (if relevant)
Time of Incident (if relevant)
Location of Incident*
Who/What is the subject of your compliant*
Summary of Complaint/Issue*

Witness Details (if relevant)

Witness Given Name
Witness Surname (family)
Witness Daytime Contact Number

Complaint Outcome

As a result of making this complaint, is there any outcome you would like? *
If yes, please provide details
If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.

Subscribe to our eNewsletter

Click here to subscribe online >

Contact Council

Coorong District Council

95-101 Railway Terrace, Tailem Bend SA 5260

PO Box 399, Tailem Bend SA 5260

Call: 1300 785 277

council@coorong.sa.gov.au

Stay Connected

Share

Map
Top