Service Agreement & Consent

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NOTE: A Service Agreement can be made between a participant and a provider or a participant’s representative and a provider. A participant’s representative is someone close to the participant, such as a family member, a friend or someone who manages the funding for supports under a participant’s NDIS plan.

1. About You

2. The NDIS and this Service Agreement

a) This Agreement is made according to the rules and the goals of the National Disability Insurance Scheme (NDIS).

b) A copy of the participant’s NDIS plan is attached to this Service Agreement.

c) The participant and the service provider agree that this Agreement is in line with the main ideas of the NDIS. These ideas include things like having more choices, achieving your goals and taking part in the community.

d) The parties agree that this Service Agreement is made in the context of the NDIS, which is a scheme that aims to:

• Support the independence and social and economic participation of people with  disability, and

• Enable people with a disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports.

3. Schedule of Supports

You are requesting the following services from PC Ability:

* All prices are GST inclusive (if applicable) and include the cost of providing the supports.

Additional expenses (i.e. things that are not included as part of a Participant’s NDIS supports) are the responsibility of the participant and are not included in the cost of the supports. This includes the cost of any equipment/aids or delivery costs of this equipment.

4. Travel

According to the NDIS price guide, PC Ability will charge travel to the location of therapy, which will be decided between the participant and the therapist. The maximum PC Ability can charge for travel per visit is 30 minutes for Metropolitan participants, and 60 minutes for remote participants. If your appointment is the final appointment of the day, you will be charged an additional travel fee from the location of your therapy back to the closest office. This will be a maximum fee of 30 minutes for metropolitan participants, and 60 minutes for remote participants.

5. Support Outside of Appointments

As per the NDIA Price Guide, the NDIA allows for the provision of non-face to face support to be charged at the rate of the line item in the service agreement. Prior to completion of activities, the therapist will explain the activities and will be directly related to the outcomes which the participant has set. These activities include but are not limited to: report writing, resource making and therapy planning.

6. Responsibilities of the Participant/Participant’s Representative

The participant/participant’s representative agrees to:

(a) Respect the rights of staff, ensuring their workplace is safe and healthy and free from harassment.

(b) Abide by the terms of your agreement with us.

(c) Understand that your needs may change and with this, your services may need to change to meet your needs.

(d) Accept responsibility for your own actions and choices even though some choices may involve risk.

(e) Tell us if you have problems with the care and services you are receiving.

(f) Give us enough information to develop, deliver and review your support plan.

(g) Provide us with information that will help us better meet your needs.

(h) Be aware that our staff are only authorised to perform the agreed number of hours and tasks outlined in your service agreement.

(i) Participate in safety assessments of your home.

(j) Ensure pets are controlled during service provision.

(k) Provide a smoke-free working environment.

(l) Pay the agreed amount for the services provided.

(m) Tell us in writing (where able) and give us notice prior to the day you intend to stop receiving services from us.

(n) To inform staff if you wish to opt out when asked.

(o) Inform the provider about how they wish the supports to be delivered to meet the participant’s needs

(p) Give the provider a minimum of 48 hours’ notice if the participant cannot make a scheduled appointment; and if the notice is not provided by then, the provider’s cancellation policy will apply.

(q) Give the provider the required notice if the participant needs to end the Service Agreement (see ‘Ending this Service Agreement’ below for more information), and

(r) Let the provider know immediately if the participant’s NDIS plan is suspended or replaced by a new NDIS plan, or the participant stops being a participant in the NDIS.

7. Responsibilities of the Provider

The provider agrees to:

(a) Review the provision of supports at least monthly with the participant.

(b) Complete an individual evacuation plan, if required.

(c) Once agreed, provide supports that meet the participant’s needs at the participant’s preferred times.

(d) Communicate openly and honestly in a timely manner.

(e) Treat the participant with courtesy and respect.

(f) Consult the participant on decisions about how supports are provided.

(g) Ensure that there is no conflict of interest and inform the participant if there is any potential for this.

(h) Provide supports that meet the participant’s needs at the preferred times.

(i) Listen to the participant’s feedback and resolve problems quickly.

(j) Give the participant a minimum of 24 hours’ notice if the provider has to change a scheduled appointment to provide supports.

(k) Keep personal information private.

(l) Keep the participant safe and ensure the safety of others.

(m) Give the participant the required notice if the provider needs to end the Service Agreement (see ‘Ending this Service Agreement’ below for more information).

(n) Protect the participant’s privacy and confidential information inclusive of the participant’s personal data, health information and other personal details gathered during the intake process. We will ensure that your information remains private during the delivery of our services.

(o) Provide supports in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules, and the Australian Consumer Law; keep accurate records on the supports provided to the participant.

(p) Issue regular invoices and statements of the supports delivered to the participant. Service Provider has policies and procedures that are built on human rights. Where allegations of abuse, neglect, violence, exploitation, or discrimination are made, (Service Provider employs a Zero Tolerance policy).

 

Emergency and Disaster Management:

Effective from 15 November 2021, all NDIS registered providers must 1) ensure continuity of supports critical to their clients before, during and after an emergency or disaster; and 2) work with their clients to undertake risk assessments and include preparedness strategies in their individual support plans.

- NDIS Legislation Amendment (Quality Indicators) Guidelines 2021

8. Cancellation Policy

In accordance with the NDIS Price Guide, the provider is able to claim 100% of the agreed fee associated with the activity from the participant’s plan. PC Ability request a minimum of 48 hours’ notice for a cancellation of a scheduled appointment to avoid the cancellation fee.

A cancellation is a short notice cancellation if the participant:

• Does not show up for a scheduled service within a reasonable time, or is not present at the agreed place and within a reasonable time when the provider is travelling to deliver the support; or

• Has given less than 48 hours’ notice for a support. To cancel a scheduled appointment, the participant or their supports can call the therapists directly, or contact PC Ability directly via our phone on 1300 077 023 or email: [email protected]

9. Payments

The provider will seek payment for their provision of supports after the participant confirms satisfactory delivery.

[If the funding for any of the supports provided under this Service Agreement is NDIA Managed:] After providing those supports, the provider will send the NDIA an invoice for those supports for the participant. The NDIA will pay your support provider directly for these supports.

[AND / OR]

[If the funding for any of the supports provided under this Service Agreement is managed by the participant: The participant has chosen to self-manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, the provider will send the participant an invoice for those supports for the participant to pay. The participant will pay the invoice by [bank transfer] within [30 days].

[AND / OR]

[If the funding for any of the supports provided under this Service Agreement is managed by a Registered Plan Management Provider:] The participant has nominated the Plan Management Provider to manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, the provider will claim payment for those supports from:

A supply of supports under this Service Agreement is a supply of one or more reasonable and necessary supports specified in the statement of supports included, under subsection 33(2) of the (NDIS Act), in the participant’s NDIS Plan currently in effect under section 37 of the NDIS Act. National Disability Insurance Scheme Act 2013

10. Changes to this Service Agreement

If changes to the supports or their delivery are required, the parties agree to discuss and review this Service Agreement. The parties agree that any changes to this Service Agreement will be in writing, signed, and dated by the parties.

11. Ending this Service Agreement

Should either party wish to end this Service Agreement they must give 1 months’ notice. If either party seriously breaches this Service Agreement the requirement of notice will be waived.

12. Feedback, complaints and disputes

If the participant wishes to give the provider feedback, the participant can talk to Alex Grigg or David Morris on 1300 077 023 or [email protected]

If the participant is not happy with the provision of supports and wishes to make a complaint, the participant can talk to Alex Grigg or David Morris on 1300 077 023 or [email protected]

If the participant is not satisfied or does not want to talk to this person, the participant can contact the National Disability Insurance Scheme by calling 1800 035 544, visiting one of their offices in person, or visiting ndis.gov.au for further information.

13. Goods and Services Tax (GST)

For the purposes of GST legislation, the Parties confirm that:

(a) A supply of supports under this Service Agreement is a supply of one or more of the reasonable and necessary supports specified in the statement included, under subsection 33(2) of the National Disability Insurance Scheme Act 2013 (NDIS Act), in the participant’s NDIS plan currently in effect under section 37 of the NDIS Act;

(b) The participant’s NDIS plan is expected to remain in effect during the period the supports are provided; and

(c) The participant will immediately notify the provider if the participant’s NDIS plan is replaced by a new plan or the participant stops being a participant in the NDIS.

14. Access to Records

My file can be accessed by NDIS Registered Auditor for audit purposes only
I agree to the following people being given access to my records. Please tick who you give permission to access your personal records:

15. Psychology Support

Please note for participants engaging in Psychology services as well as other therapeutic services within PC Ability, PC Ability therapists have access to the same case management system, whereby all case notes are viewable amongst therapists. This remains confidentially stored in our case management system. If you would like certain information to not be shared amongst the other services within PC Ability, please report this to your Psychologist.

16. Information Storage

The NDIS Commission may collect personal information about you from you, your representative or a third party. Using forms, online portals and other electronic or paper correspondence to collect this information. The NDIS Commission or we as service providers may collect information directly. The NDIS Commission may also obtain personal information collected by other Commonwealth agencies, State or Territory government bodies, or other organisations. From time to time, the NDIS Commission may receive personal information from members of the public without it being requested.

The NDIS Commission and we as service providers will not ask you for any personal information which we do not need. The Privacy Act requires that we collect information for a purpose that is reasonably necessary for, or directly related to, a function or activity of the NDIS Commission.

When the NDIS Commission collects personal information, we are required by the Privacy Act to notify you of a number of matters. These include the purposes for which we collect the information, whether the collection is required or authorised by law and any person or body to whom we usually disclose the information. The NDIS Commission generally provides this notification by having Privacy Notices on our paper-based forms and online portals.

17. Contact Details

Participant Contact details

The provider can be contacted on:

Contact Details

18. Agreement Signatures

The parties agree to the terms and conditions of this Service Agreement.

This agreement has been explained verbally.