Test New Forms – Gold Creek Country Club

Feedback

"*" indicates required fields

Full Name*

Anonymous

Email Address

Mobile No

Are you a*

Member

Visitor

Staff

Resident

Other

Date of Visit*

DD slash MM slash YYYY

Time of visit

Hours

Minutes

AM/PM

Would You Recommend Us to Others?*

Area of Feedback*

Other*

Your Feedback or Comments Rating (1 - 5 stars)

Rate your Experience

(1 = Poor, 5 = Excellent)

Condition of Facility*

Service*

Product Quality*

Presentation of Area*

Staff Friendliness*

Value for Money*

What could we improve on?*

What did we do well on?*

Would You Like to Be Contacted for Follow-Up or Promotions?*

Yes, please contact me

No, thank you

Any Other Comments or Suggestions?*

Upload a Photo or File

Max. file size: 2 MB.

Would you like a follow-up?*

Yes

URL

This field is for validation purposes and should be left unchanged.

Capital Works Feedback

"*" indicates required fields

Full Name

Email Address

Your Suggestion / Idea*

Would this benefit*

Other*

Would you be happy for us to contact you about this idea?*

Yes

Instagram

This field is for validation purposes and should be left unchanged.

Golfer – Out of bounds reporting

"*" indicates required fields

Full Name*

Email Address*

Mobile No*

Are you a:*

Member

Visitor

Date of Incident*

DD slash MM slash YYYY

Time of Incident*

Hours

Minutes

AM/PM

Hole Number (1 - 18)*

Please enter a number from 1 to 18.

Distance to Greens - Marker*

Location

You can drag the marker for better precision

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Longitude

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Latitude

Location*

Description of Shot*

Ball Description

1. Brand/Make Model*

2. Ball No*

3. Other Markings

Yes

Other Markings*

Did the ball hit a structure or person?*

Yes

If yes, explain:*

Did you speak to anyone (e.g., resident)?*

Yes

If yes, details*

Upload Photos or Notes

Max. file size: 2 MB.

Would you like a follow-up?*

Yes

Facebook

This field is for validation purposes and should be left unchanged.

Resident Damage Report

"*" indicates required fields

Full Name*

Email Address*

Mobile No*

Are you a member:*

Yes

Address of Incident

Unit No

Street No*

Street Name*

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Suburb

This field is hidden when viewing the form

State

This field is hidden when viewing the form

Postcode

When were you aware of the damage?*

DD slash MM slash YYYY

if known, when did you become aware of the issue

Time of Incident*

Hours

Minutes

AM/PM

Description of Damage*

Was anyone injured or involved?*

Upload Photos (damage, ball, etc)*

Drop files here or

Max. file size: 2 MB.

Required, photos of damage - Minimum 3 photos

Have you previously reported a similar incident?*

Yes

Are you seeking assistance in repairs?*

Preferred Contact Method*

Phone

Damage may need to be inspected by GCCC or Authorized Representative prior to repair or modificaiton

Did you find the ball that caused the issue?

1. Brand/Make Model*

2. Ball No*

3. Other Markings

This field is for validation purposes and should be left unchanged.

Incident Report

"*" indicates required fields

Incident Details

Date of Incident*

DD slash MM slash YYYY

Time of Incident*

Hours

Minutes

AM/PM

Location

You can drag the marker for better precision

This field is hidden when viewing the form

Latitude

This field is hidden when viewing the form

Longitude

Type of Incident (tick all that apply)*

Injury

Near Miss

Property Damage

Behavioural Issue

Safety Hazard

Theft/Vandalism

Other

Other*

Description of the Incident (Detailed)*

Was medical attention required?*

Yes

Personal Injuries

What treatment was provided?*

Who provided First Aid?*

Was an Ambulance Required?*

Yes

Involved Parties

Person(s) Involved*

Name(s), Contact (if available), Member/Visitor/Staff/Contractor/Resident

Witnesses*

Name(s), Contact Info (if available)

Reporter Information

Your Full Name*

Position/Role*

Member

Staff

Contractor

Resident

Visitor

Mobile No

Evidence

Upload Photos/Documents

Drop files here or

Max. file size: 2 MB.

(e.g., damage, injury, hazard, CCTV stills)

Immediate Actions Taken

Notes (e.g., area isolated, first aid administered, person escorted)

Follow-Up Actions Required*

(repairs, signage, investigation)

Reported To*

(Supervisor, GM, Safety Officer, etc.)

Close-Out Date / Notes

Phone

This field is for validation purposes and should be left unchanged.