DPV Health Public Portal
 1. Type of Feedback 
 Complaint 
 Compliment 
 Suggestion 
Source of Notification
Date Received
Date Acknowledged
 2. Location/ Site for which feedback is being provided 
 3. Service Used 
 4. Your Details 
Are you a ......? Specify who you are
First Name Last Name
Date of Birth
Address
Suburb/City Postcode
State
Contact Number Email
Interpreter required
 Yes 
 No 
 Primary Language
Other Language
Do you identify as Aboriginal or Torres Strait Islander?
 Yes 
 No 
Do you identify as LGBTIQ+?
 Yes 
 No 
 5. Details of Feedback (please provide as much detail as possible) 
Check Spelling
 6. How would you like to be contacted in response to your Feedback (you can select more than one option) 
Submit
Submit this Feedback. RiskMan will check if you have completed all the mandatory fields.