Completing this form
When completing the form, please remember it doesn't matter how much or how little information you have, every detail is valuable. It should only take a few minutes of your time to complete.
This form allows you to provide information about a health provider, an organisation, or their employees.
Before you start
There are some issues that we cannot help you with. You can report these things to other authorities:
- Reports about patient safety or harm - submit these to the Australian Health Practitioner Regulation Agency (AHPRA)
- Rude, racist, inappropriate professional conduct, not listening, dismissive, service quality or interaction issues (also AHPRA)
- Suspected Medicare, pharmaceutical or Centrelink fraud by a member of the public (not a health provider or their employee) – submit these to Services Australia
- COVID-19 vaccination process and booking queries: COVID-19 vaccines
- COVID-19 vaccination issues in pharmacies: submit these to the Pharmacy Program Administrator PPA tip-off form
- COVID-19 vaccination certificate is incorrect: call the Australian Immunisation Register on 1800 653 809
- Tip-offs about a member of the public (not a health provider) who has a false COVID-19 vaccination certificate or is creating false COVID-19 vaccination certificates for themselves or others: call Services Australia on 13 15 24
- Tip-offs about the business practices for the sale of Rapid Antigen Tests that may be of concern: call Australian Competition and Consumer Commission on 1300 302 502 or via Report a consumer issue ACCC.
Should you require more information about what can be reported on this form please refer to Health provider related tip-offs page
Your feedback has been submitted
Thank you for taking the time to provide feedback. It will be used to make improvements to this website.