The Barna Co
Lasting Connection
First name* Last name*
Telephone* Your email*
Date of Occurance * I am a ParticipantFamily member or friendAdvocateCarerStaff memberOther
Are you making this complaint on behalf of a person with a disability? * YesNo Do you require any help with communication? e.g. Interpreter or National Relay Service YesNo
If you require assistance, please provide details Please advise your desired outcome as a result of raising this concern/providing this feedback?
Please provide details of your complaint. Details such as the date/time the issue occurred, the outline of the issues involved*
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