NDIS Service Agreement

NDIS Service Agreement

1. Parties

This Service Agreement is for:

Client First Name *

Client Surname Name *

Client Date Of Birth *

NDIS Number *

a participant in the National Disability Insurance Scheme (client), and is made between:

Client Representative Name *

Just Notice Counselling and Consultancy *

Date *

2. The NDIS and this Service Agreement

This Service Agreement is made for the purpose of providing supports under the clients NDIS plan.

A copy of the clients NDIS Plan is/is not attached to this Service Agreement. 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 client 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.
NDIS plan to be provided to Just Notice Counselling

3. Schedule of supports

Just Notice Counselling agrees to provide the client Physiotherapy services. The supports and their prices are set out in the attached Schedule of Supports. 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 client NDIS supports) are the responsibility of the client / clients representative and are not included in the cost of the supports.

4. JUST NOTICE COUNSELLING Responsibilities

Just Notice Counselling agrees to:

review the provision of supports at least annually with the client;
once agreed, provide supports that meet the client's needs at the client's preferred times;
communicate openly and honestly in a timely manner;
treat the client with courtesy and respect;
consult the client on decisions about how supports are provided;
give the client information about managing any complaints or disagreements and details ofJust Notice Counsellingcancellation policy;
listen to the client’s feedback and resolve problems quickly;
give the client a minimum of 24 hours notice if Just Notice Counselling has to change a scheduled appointment to provide supports;
give the client the required notice if Just Notice Counselling needs to end this Service Agreement (see "Ending this Service Agreement" below for more information);
protect the client's privacy and confidential information;
provide supports in a manner consistent with all relevant laws, including the NDIS Act 2013 and Rules, and the Australian Consumer Law;
keep accurate records on the supports provided to the client; and
will issue invoices and statements of the supports delivered to the participant as per the NDIA Terms of Business for Registered Providers as requested

5. Responsibilities of the client / client representative

The client / client representative agrees to:

informing JUST NOTICE COUNSELLING AND CONSULTANCY about how they wish the supports to be delivered to meet the client needs;
treat Just Notice Counselling workers with courtesy and respect;
talk toJust Notice Counselling if the client has any concerns about the supports being provided;
giveJust Notice Counselling the required notice if the client cannot make a scheduled appointment, noting that if the notice is not provided , cancellation policy will apply;
giveJust Notice Counselling the required notice if the client needs to end this Service Agreement (see 'Ending this Service Agreement' below for more information); and
letJust Notice Counselling know immediately if the client NDIS plan is suspended or replaced by a new NDIS plan, or the client stops being a participant in the NDIS.

6. Payments

Just Notice Counselling will seek payment for their provision of supports after the supports have been delivered.

SELF MANAGED - The client / client representative has chosen to self-manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, [Practice Name] will send the client / client representative an invoice for those supports for the client / client representative to pay. The client / client representative will pay the invoice by direct debit / EFT within 7 days. NDIA MANAGED - The client has nominated the NDIA to manage the funding for supports provided under this Service Agreement. After providing those supports, [Practice Name] will claim payment for those supports from the NDIA. PLAN MANAGED - The client has nominated the Plan Management Provider to manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, Just Notice Counselling and Consultancy will claim payment for those supports from

Plan Manager Provider Name

Plan Manager Email Address

Start Date

7. 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.

8 Ending this Service Agreement

Should either party wish to end this Service Agreement they must give 2 weeks notice. If either party seriously breaches this Service Agreement the requirement of notice will be waived.

9. Feedback, complaints and disputes

If the client wishes to give Just Notice Counselling feedback or is not happy with the provision of supports and wishes to make a complaint, the participant can talk to Name on 0484 144 417 or email renee@justnotice.com.au

If the client is not satisfied or does not want to talk to this person, at any time, they can make a complaint to the NDIS Commission. Complaints to the NDIS Commission can be lodged:

online at www.ndiscommission.gov.au; or
by phone on: 1800 035 544.

10. Goods and Services Tax (GST)

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

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 NDIS Act, in the client's NDIS Plan currently in effect under section 37 of the NDIS Act;
the client's NDIS Plan is expected to remain in effect during the period the supports are provided; and
the client / client representative will immediately notify the provider if the client's NDIS Plan is replaced by a new plan or the client stops being a participant in the NDIS.

11. Cancellation Policy

At Just Notice Counsellingwe value consistent and high quality intervention.

If you need to cancel an appointment it is recommended it occur 48 hours prior to your appointment to avoid a cancellation fee. If you contact Just Notice Counsellingafter 3pm the day before your appointment or on the day of your appointment there will be a cancellation fee of 100% charged to your account and payment due on the day of the no attendance/cancellationt.

Should your therapist arrive at your scheduled appointment and you and your child are not at home or at the location of the appointment with no prior notice, the scheduled session including travel will be charged at 100% of the scheduled fee for that session. WhereJust Notice Counsellingcancels a support due to operational reasons, the service will be rescheduled at no penalty to either party.

Where multiple cancellations or no shows occur in a 12-month period,Just Notice Counselling will initiate contact with the family and their support network to establish the supports we are providing are best suited to the family dynamics and the needs of the child.

I have read & understood the cancellation policy *

12. Contact details

The Client Representative can be contacted on:

Client Representative Name *

Alternative contact person

Address *

Phone *

Email Address of Client Representative *

Just Notice Counsellingcan be contacted on:

Renee Cassidy *

0484 144 417 *

renee@justnotice.com.au *

PO Box 36 Busselton WA 6280

13. Schedule of supports

I/we agree to pay for treatment/ therapy sessions provided by Just Notice Counselling by through claiming against the National Disability Insurance Scheme (NDIS) service plan. Working with the NDIS we have been allocated physiotherapy funding for the service year (enter service dates)

Start Service Date *

Finish Service Date *

Frequency of support *

WeeklyFortnightlyMonthly As scheduled

Price & Payment Information

Therapy and travel will be charged at $190 for capacity building and travel as per NDIS item numbers. Therapy session will also incur travel charges if travel is required.

All prices will be adjusted if there is any change in the NDIS price guide during the service agreement period.

Just Notice Counselling will claim funding from the following support category: CB Daily Activity if agency managed

14. Agreement signatures

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

Signature of Client Representative *

Draw signature|Type signatureClear

Name of Client Representative *

Signed Date *

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