In terms of Section 88A of the National Health Act, 2003 (Act No. 61 of 2003), any person aggrieved by any decision of the Office or any finding and recommendation of the Ombud in relation to a matter regulated by this Act, or a person acting on his or her behalf, may within 30 days of gaining knowledge of that decision, lodge a written appeal with the Minister, who must appoint an independent ad hoc tribunal to whom the appeal received must be submitted.

Name of health establishment

Address of health establishment

Name of person lodging appeal

Contact information of person lodging the appeal

Decision, finding or recommendation against which appeal is being lodged

Date of such finding, appeal or recommendation

Grounds for appeal

In annexure:

Any documentation or representations relevant to the appeal