{"id":185,"date":"2026-05-02T16:38:01","date_gmt":"2026-05-02T06:38:01","guid":{"rendered":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/?page_id=185"},"modified":"2026-05-02T16:39:41","modified_gmt":"2026-05-02T06:39:41","slug":"complaint-form","status":"publish","type":"page","link":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/complaint-form\/","title":{"rendered":"Complaint Form"},"content":{"rendered":"<div class=\"inner-sec mb-5\">\n<div class=\"container\">\n<div class=\"row justify-content-center\">\n<div class=\"col-lg-7 col-md-10 col-sm-12\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f189-o1\" lang=\"en-AU\" dir=\"ltr\" data-wpcf7-id=\"189\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/devsite\/chosen-care\/wp-json\/wp\/v2\/pages\/185#wpcf7-f189-o1\" method=\"post\" class=\"wpcf7-form init cf7mls-no-scroll cf7mls-no-moving-animation\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"189\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_AU\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f189-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:189,&quot;conditions&quot;:[],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;repeater_remove_button&quot;:&quot;bottom&quot;}}\" \/>\n<\/fieldset>\n<div class=\"ref_form_box mb-4\">\n\t<div class=\"row\">\n\t\t<div class=\"inner-heading\">\n\t\t\t<p>Your Concerns Matter: Share Your Complaints for a Better Service.\n\t\t\t<\/p>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>Full Name\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_input\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>Email Address\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_input\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>Phone Number\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_input\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>What is your complaint about? (Provide some details to help us understand your concerns. You can include what happened, where it happened and who was involved)\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_input\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"complaint-about\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Message\" name=\"complaint-about\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>Did someone witness the incident \/ complaint? Would they be willing to be contacted regarding your complaint? If so, provide the name and contact details. (Inform the witness that they may be contacted by the companyfc to discuss the matter).\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_input\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"incident-complaint\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Message\" name=\"incident-complaint\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>How can we help to fix this problem or complaint?\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_input\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"problem-complaint\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Message\" name=\"problem-complaint\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 col-12 mb-3\">\n\t\t\t<div class=\"ref_form_box_label\">\n\t\t\t\t<p>Consent\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"ref_form_box_radio\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"consent\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"consent\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I agree with the Privacy Policy before submitting this form.<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"col-lg-12 col-md-12 contact-btn mt-3\">\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n\t\t\t<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/full-width.php","meta":{"footnotes":""},"class_list":["post-185","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/pages\/185","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/comments?post=185"}],"version-history":[{"count":3,"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/pages\/185\/revisions"}],"predecessor-version":[{"id":190,"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/pages\/185\/revisions\/190"}],"wp:attachment":[{"href":"https:\/\/jr-technologiesweb.com\/devsite\/chosen-care\/wp-json\/wp\/v2\/media?parent=185"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}