Free Sample NDIS Service Agreement Template

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Free Sample NDIS Service Agreement Template

Sample NDIS Service Agreement

1. Parties to the Agreement

This Service Agreement is between Johann Harvey, a participant in the National Disability Insurance Scheme, referred to as "the Participant" or "the Client", and [Your Name], the provider of services, referred to as "the Provider".

2. Duration of the Agreement

This Agreement will commence on [Start Date] and continue until [End Date] or until terminated by either party in accordance with the terms of this Agreement.

3. Purpose of the Agreement

The purpose of this Service Agreement is to set out the terms and conditions under which NDIS supports and services will be provided to the Participant.

3.1 Services Provided

The Provider agrees to deliver the following services to the Participant as per the NDIS Plan:

  • Service 1: Daily living support, including assistance with meal preparation and household tasks.

  • Service 2: Transportation services to and from medical appointments and community activities.

  • Service 3: Occupational therapy sessions to enhance functional independence.

3.2 Service Delivery

The services will be delivered in accordance with the Participant's NDIS Plan goals and objectives, and as mutually agreed upon between the Participant and the Provider.

4. Responsibilities

4.1 Responsibilities of the Provider

The Provider agrees to:

  • Provide services that meet the Participant’s individual needs;

  • Review the provision of services regularly with the Participant;

  • Communicate openly and honestly with the Participant;

  • Treat the Participant with courtesy and respect;

  • Respect the Participant's privacy and confidentiality;

  • Give the Participant information about managing any complaints or disagreements and details of the Provider’s cancellation policy.

4.2 Responsibilities of the Participant

The Participant agrees to:

  • Inform the Provider about how they wish the services to be delivered, to meet the Participant’s needs;

  • Treat the Provider with courtesy and respect;

  • Talk to the Provider if the Participant has any concerns about the services being provided;

  • Give notice if the Participant cannot make a scheduled appointment;

  • Participate constructively in planning and review meetings;

  • Provide accurate and complete information to enable effective service delivery;

  • Pay fees for services as per the agreement, where applicable.

5. Payment

The Provider will claim payments for all services provided under this Service Agreement as per the NDIS Price Guide. Payments will be made by [Payment Method].

6. Changes to the Agreement

If changes to the services or their delivery are required, both parties agree to discuss and review this Service Agreement. Any necessary changes will be documented and signed by both parties.

7. Termination of the Agreement

This Service Agreement can be ended by either party with [Notice Period] notice. If either party seriously breaches a provision of this Agreement, the requirement of notice will be waived.

8. Contact Information

The Participant can contact the Provider on:

Phone: [Your Number]
Email: [Your Email]

The Provider can contact the Participant on:

Phone: 222 555 7777
Email: johann@you.mail

Signature/s

Both parties need to sign this Service Agreement to acknowledge understanding and acceptance of its terms and conditions.

[Your Name]

Johann Harvey

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