MEDICARE CLIENT COMPLAINT RECORD Please enable JavaScript in your browser to complete this form.Name of Person issuing the complaint *FirstLastCompany NameContact Number *Email Address *Complaint Details (please included all details, including the date, an order reference number, serial numbers and images if applicable.) *Complaint Related to: (please tick the appropriate field) *ProductServiceDeliveryAdministrativeOther (please specify)Other (details as above)Please rate the seriousness of your complaint from 1 (not very serious) to 10 (extremely serious)? Selected Value: 0 PhoneSubmit KEMPTON PARK BRANCH PRETORIA BRANCH CAPE TOWN BRANCH
