Service Agreement

This Service Agreement is made according to the rules and goals of the National Disability Insurance Scheme (NDIS). This Agreement may change with updates to the NDIS Price Guide.

It describes the roles of the participant and Allay Occupational Therapy (Allay).

Services provided by Allay Occupational Therapy
At Allay we will help you with your goals in your home, school, community or at our clinic.
At Allay we provide:
Occupational Therapy: to help people develop, recover, or maintain function in daily living skills through assessment and therapy.
Therapy Assistance: support therapists by implementing supervised therapy plans, working directly with clients to carry out prescribed activities.
Key Workers in Early Childhood: coordinates care and services across a team, by collaborating with other supports, integrating strategies and ensuring coordinated communication and planning.

Changing this Agreement
If you want to change this agreement, please talk to your OT.
If you or Allay need this agreement to end, you need to give 4 weeks’ notice.
If this agreement is broken by you or Allay, the 4 weeks’ notice will not apply.

Funding
In this Service Agreement, we will agree on how many hours from your NDIS Plan can be used by your OT and TA.

Reporting
Allay will write a report about your OT and TA sessions for the NDIS before the end of your plan year.
We will claim for the time spent on your report from your NDIS Plan.
If you need the report earlier than planned, discuss this with your OT.

Allay’s Responsibilities
Allay agrees to:
• Look at the service agreement with you at your Plan Commencement or earlier if needed. This may be talking about the work we do, planning how we will use hours, or signing a new agreement
• Work with you to reach your goals
• Treat you with respect
• Talk to you about plans for sessions
• Listen to your questions or worries about our services and work together to solve problems
• Keep records of work done
• Keep your work confidential unless there are worries about safety

Your Responsibilities
You as the participant and your support people agree to:
• Tell your OT what your needs and goals are
• Treat your OT and TA with respect
• Talk to your OT if you have any questions or worries
• Tell your OT if reports need to be finished earlier than planned
• Tell Allay how your sessions will be paid for and if this changes

Cancellation Policy
If you cannot come to a session, you need to call Allay 2 business days before the session to cancel.
If you don’t call us with 2 business days’ notice, we will claim the cost of the session to your NDIS Plan.

Confidentiality and Consent
We are committed to upholding the highest standards of confidentiality regarding your personal information. We recognise the critical importance of privacy and are dedicated to safeguarding your sensitive data. We will gather consent to collect, use, retain and disclose information.
However, if concerns arise regarding your safety or the safety of others, we have a legal and ethical obligation to report this information to the appropriate authorities. This ensures the well-being of our clients and the broader community. In such instances, we will provide only factual, objective information to facilitate necessary support.

Travel
If your OT or TA drives to you for sessions, travel time, road tolls, parking fees and car running costs will be claimed from your NDIS Plan.
If you live in Melbourne or Geelong, Allay will claim a maximum of 30 minutes each way.
If you live further away, Allay will claim a maximum of 60 minutes each way.
Car running costs are claimed at 99 cents per kilometre. Road tolls or parking fees are based on individual costs if they occur.

Payment Terms
Allay will claim for services including:
• Sessions
• Note writing
• Phone calls
• Emails
• Report writing
• Making resources for you
• Travel costs
• Car running costs

Self-Managed Participants
If you are a Self-Managed Participant, this means that you have chosen to pay for the invoices related to the supports you receive through your NDIS Plan.
Allay will email you an invoice in the week after a session.
The payment is due within one week of receiving your invoice.
If you have not paid your invoice, we will send reminders to you.
If you are unable to pay your invoice, we will pause OT until payment is finalised.

Allay Quality Assurance
All Allay OT’s are registered with the Australian Health Practitioner Regulation Agency (AHPRA) and the Quality and Safeguards Commission as OTs. Allay follows policies and laws that make sure they work in a high quality and safe way.
Allay’s Privacy Policy, Child Safety and Wellbeing Policy and Child Safe Standards are on our website if you want more information.

Complaints
To make a complaint, you can talk to your OT, call our leadership, e-mail or send a letter to Allay.
Allay will review all complaints made and will work with you to try to find a solution.
For more information, please read our Fact Sheets provided.

Service Agreement

Consent for Services

Please tick that you have read and agree to the below. If you have any questions or concerns, talk with your OT in your session.

Consent to collect, use, retain, share and receive important, relevant information. Consent has been provided in our Intake Form or Consent Form.

Consent to Take Photos or Video. Take photos or video of you during sessions for resources.

Use Therapeutic Items Therapeutic items, such as weighted blankets, aromatherapy items, food or drinks, toys or movement equipment are used at your own discretion and risk.

Use Therapy Dog Our Therapy dog is trained to work with people and may be at our clinic and come to a session. Our Therapy dog is checked regularly to keep healthy. Let your OT know if you have any allergies or prefer not to be in close contact with animals. If an allergic reaction or injury happens when working with the dog, that is at your own risk.

Feedback We complete Feedback Surveys of our services routinely. We use this information to improve our services.

Service Updates and Marketing We keep you updated on services at Allay in email or SMS.

Quality and Safeguards Audit Allay gets audited on a regular basis to ensure we provide quality and safe services. This includes reviewing our client work and filing, policies, registers and practice filing.

Funding

If you are unsure how to fill in this form, you can leave parts blank, or get help from your Support Coordinator, your OT, family or other supports.

Participant Details:

Your NDIS Number and Plan Dates can be found on your NDIS Plan.

Name:

First Last

Date of birth:

NDIS Number:

NDIS Plan Dates:

Funding Allocation:

This helps your OT know how many hours are for this Plan Period. It may be divided over OT or TA sessions, travel costs, note writing, phone calls, emails, reporting or making resources for you.

Reporting:

Any reporting will be finalised before the end of your NDIS Plan period and will be emailed to the NDIS.

Email address to send report to:

If you need your report completed earlier, please list the due date:

Reason report is needed earlier:

Signature:

I, (write your name)

Relationship to the client (if not the client)

Have read, understand and completed the forms in this Service Agreement regarding accessing services with Allay.

Signature

Date