Service Agreement

Parties

This Service Agreement is between Atypical Solutions TM Pty Ltd and:

First Name *

Last Name *

Date of Birth *

NDIS Number *

2. Client Information

Does the client have a plan nominee or legally appointed guardian?

YesNo

Nominee/Guardian Name:

Role

Phone Number

E-mail address

Has a copy of the client's NDIS plan been provided to us? *

YesNo

Please upload a copy of the NDIS Plan

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The client’s funding is: *

Self ManagedPlan ManagedNDIA ManagedPrivate Fee for Service

Plan Manager Provider's Name:

Plan Manager Provider's Email Address:

1. Purpose of the Agreement

This Agreement outlines the support services provided by Atypical Solutions based on your NDIS plan, aged care home package, or if you're a self-funded participant. Our goal is to help you increase your independence, improve your social and economic participation, and ensure you have control over how your supports are delivered.

2. Schedule of Supports

Atypical Solutions agrees to provide the support services outlined above.

If you would like a detailed Schedule of Supports, you can request one at any time.
Otherwise, Atypical Solutions will charge in line with the current NDIS Pricing Arrangements at the maximum rates for each support agreed to in this Service Agreement.
Any additional expenses not included in your support plan will be the responsibility of you or your representative.

3. Payment Agreement

By signing this agreement, you agree to:

Pay for supports provided by Atypical Solutions by claiming the costs from your nominated funding source (e.g., your NDIS plan or home care package).
Confirm that you have access to the necessary funding in your plan to cover these supports.

Atypical Solutions will provide support services for the duration of this agreement at the maximum scheduled rates based on the NDIS Pricing Arrangements and Aged Care Pricing Standards.

Atypical Solutions can also claim for the following services, in line with relevant laws:

Non-Face-to-Face Support Provision
Provider Travel
Provider Travel – Non-Labour Costs
Transport Costs
Short Notice Cancellations
NDIA/HCP Requested Reports

If there are insufficient funds in your plan, or if your plan expires, Atypical Solutions reserves the right not to provide services or cancel any future appointments. In such cases, any outstanding fees not covered by your nominated funding source will be your responsibility or that of your representative.

4. Our Responsibilities

Atypical Solutions will:

Review your supports at least once a year.
Ensure your supports are provided at times that work best for you.
Communicate openly and treat you with respect.
Listen to your feedback and resolve any concerns quickly.
Keep your personal information private and secure.

5. Your Responsibilities

You agree to:

Let us know how you want your supports delivered.
Treat Atypical Solutions workers respectfully.
Tell us if you can’t attend a scheduled appointment.
Inform us if your NDIS plan changes or ends.

6. Payment Methods

You can pay for your supports through the following options:

Self-Managed NDIS Plan
Plan Managed NDIS Plan
NDIA Managed NDIS Plan
Private Fee for Service
Home Care Package

7. Changes to the Agreement

If any changes are needed, we’ll discuss and agree on them in writing.

8. Ending the Agreement

Either you or Atypical Solutions can end this Agreement with two weeks’ notice. If there’s a serious issue, the Agreement can end immediately.

9. Feedback, Complaints, and Disputes

If you have concerns, you can reach out to our Executive Manager, Tara Maggs, at tara@atypicalsolutions.com.au. If unresolved, you can contact the NDIS Commission or Aged Care Quality and Safety Commission.

10. Cancellation Policy

We have a cancellation policy to ensure fairness:

Short Notice Cancellation (2 Business Days) : If you cancel an appointment less than 2 business days before it is scheduled to happen, or if you don’t show up at all, you will be charged 100% of the agreed fee.
Short Notice Cancellation (7 Days) : For Disability Support Worker services, if you cancel less than 7 days before your appointment or miss it, the same fee applies.
Waiver of Cancellation Fees : We may waive the cancellation fee if there are special circumstances, like health issues or emergencies.
Group Sessions : If you cancel last minute for a group session and we can’t find another participant to take your spot, we may still charge you for the session.
What Happens if Atypical Solutions Cancels : If Atypical Solutions cancels your appointment for operational reasons, we will reschedule the session at no extra cost to you.

11. GST (Goods and Services Tax)

GST Exemption : The supports under this Service Agreement are GST-exempt, meaning they are not subject to GST charges, as per the client’s NDIS plan or aged care funding.
What This Means : Since these supports are part of your NDIS plan or aged care funding, we don’t charge GST for the services we provide to you.
If Your Plan Changes : If your NDIS plan ends or is replaced with a new one, or if you stop being a participant, you need to inform us right away.

By signing this agreement, you confirm that you understand and agree to the terms outlined above.

I have read and understood the cancellation policy: *

Yes

13. Consents

General Consent to Services

I agree to receive services from Atypical Solutions as outlined in this Service Agreement. I understand the scope and nature of the services to be provided.

Privacy and Confidentiality Consent

I consent to Atypical Solutions collecting, storing, and using my personal and sensitive information in accordance with the Privacy Act 1988. I understand that my information will be kept confidential and only used for the purpose of providing services.

Information Sharing Consent

I consent to Atypical Solutions sharing relevant personal information with other healthcare providers, family members, or support networks as necessary for the provision of services. The types of information that may be shared include, but are not limited to, medical history, care plans, and service records.

Emergency and Medical Consent

I consent to Atypical Solutions contacting emergency services or medical professionals in case of an emergency and sharing necessary medical information with emergency responders to ensure my safety and well-being.

I consent to Atypical Solutions providing basic first aid in the event of an injury or medical emergency during participation in activities or programs.

I understand that:

Atypical Solutions staff may administer basic first aid treatment, including but not limited to bandaging, wound cleaning, or applying cold packs.
In the case of a serious incident, Atypical Solutions will contact emergency services (000) and provide them with relevant medical information.
Every effort will be made to notify the emergency contact person as soon as possible.
Atypical Solutions is not liable for any costs associated with medical treatment or emergency services.

I confirm that I have disclosed any relevant medical conditions, allergies, or specific first aid requirements to Atypical Solutions

Third-Party Consent

I consent to Atypical Solutions communicating with third parties, such as government agencies, funding bodies, or other service providers, to coordinate care and funding. This includes sharing information with the NDIS or My Aged Care as required.

Review and Feedback Consent

I consent to participate in service reviews and provide feedback to Atypical Solutions for quality improvement purposes. I understand that my feedback may be used in an anonymised form for service improvement and reporting.

Technology and Digital Services Consent

I consent to the use of digital tools, Telehealth services, or electronic health records by Atypical Solutions for my care. I understand how my digital data will be managed and protected in accordance with applicable privacy laws.

Marketing and Communication Consent

I consent to receive communications from Atypical Solutions about services, updates, and events. I understand that I have the option to opt-in or opt-out of marketing communications at any time.

YesNo

Consent for Participation in NDIS Audits

As part of our commitment to quality improvement and compliance with regulatory requirements, Atypical Solutions may participate in audits conducted by the National Disability Insurance Scheme (NDIS). These audits help ensure that we are delivering high-quality services and adhering to all relevant standards and guidelines.

We are seeking your consent to include your information in these audits. You have the option to participate anonymously or with your full details provided. Your choice will not affect the services you receive from Atypical Solutions.

Yes

I consent to participate in NDIS auditsAnonymously (my personal information will not be identifiable)With full details provided (my personal information will be included)

No

I do not consent to participate in NDIS audits

14. Signatures

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

I have read and understand the terms of the agreement *

Yes

Agreement Start Date: *

Agreement End Date:

Today’s Date *

Signature *

Draw signature|Type signatureClear

Full name of Client / Representative *

Tara Maggs

Director

Atypical Solutions TM Pty Ltd