Tobacco Plain Packaging Complaints Form

If you would like to report a potential breach of the Tobacco Plain Packaging Act 2011, please complete the form below

Your details

Title:

Given name:

Surname:

Address:

Suburb/Town:

State:

Postcode:

Phone Number:

Email:

Complaint Details

Business Type*

Business Name*

Address*

Suburb/Town:*

State:*

Type of potential breach:*

Type of tobacco product:*

Brand, variant, manufacturer:

Date of potential breach DD/MM/YYYY:*

Provide a brief account of the potential breach:*

Do you require a response from the Department of Health and Ageing? :

Yes No

* Mandatory fields

Other ways you can report a potential breach include:

Email: Plain Packaging Complaints at Department of Health and Ageing

Phone: 1800 062 971

Fax: 02 6289 7837

Post: Tobacco Plain Packaging Complaints

Tobacco Control Taskforce

MDP 701, GPO Box 9848

Canberra ACT 2601

National Health Reform