Transitions- It's all in the Prep!

Service Agreement

Service Details

A new school year often means change in routines and environments are inevitable, and like all things, the only thing you can guarantee in life is change, so let’s get prepared!

Our program supports the preparation needed for a new school year. Your young person may have a new teacher, classroom, peers or even an entirely new school and we aim to support young people to manage what they can control, be informed about what’s to come and fill up their personal tool kit with strategies that work for them. The skills, tools and strategies gained can also be transferable in preparation for any change a young person is facing.

This program is offered as a 6-hour package during the school holidays. Our practitioners will meet directly with you and your young person to understand and identify individual needs, develop tailored resources and tools and create a ‘ back to school plan’.

Participant Details

Please complete and submit this form to proceed with support. Once complete, your answers to the below questions will form your Service Agreement. You will be asked to agree to our Terms and Conditions and the costs of the program. You will receive a copy of your answers once submitted.

Please indicate whether you will be funding the program by NDIS or Fee for Service (FFS): *

NDISFee for service

I am... *

Plan ManagedSelf ManagedAgency Managed

Please list your Plan Manager's name and email *

I give approval for a Service Booking to be made for the value of the program

*

NDIS number *

NDIS Plan Dates *

Please upload a copy of your NDIS plan

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Participant first name *

Participant last name *

Participant birth date *

Participant Preferred Pronouns

He/Him/HisShe/Her/HersThey/Them/TheirsOther (please specify below)

Preferred Pronouns Comments

Parent/Caregiver first name *

Parent/Caregiver last name *

Email Address *

Phone number: *

Home address *

Is there any other information you would like us to know about your child?

How much will it cost?

The cost is $193.99 per hour for a duration of 6 hours, which includes a combination of face-to-face and non-face-to-face support.

Additional fees will apply for travel. Travel will be charged at the same hourly rate of $193.99. Up to 30 minutes of travel time to the appointment and back to the practitioner's usual place of work can be claimed.

This totals $1,163.94 (exclusive of any applicable travel charges).

Please note if using NDIS funding, this will come from your Improved Daily Living Budget.

The relevant policies are:

T&C's Autism SA NDIS

T&C's Autism SA FFS

I have read and accept the Terms and Conditions of this service, including the cancellation policy.

*

I have adequate funding available under my Improved Daily Living Budget.

*

I agree to the cost for the package as outlined above.

*

Please sign *

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