NDIS Service Agreement

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Document Number SA-006

Version 3.0

Effective Date 27 July 2025

Next Review 27 July 2026

Approved By L. Winter

Owner L. Winter

0% Complete

This Service Agreement sets out the supports and services that Abilitive Pty Ltd (the Provider) will deliver to you (the Participant) under the National Disability Insurance Scheme (NDIS). Please read this agreement carefully before signing.

1. Parties to this Agreement ▼

THE PROVIDER

Abilitive Pty Ltd

ABN 84 643 123 559

NDIS Registration Number 4-FZS39M6

Address: 27 Advantage Road, Highett, VIC 3190

Phone: 0421 420 838

Email: admin@abilitive.com.au

THE PARTICIPANT

Full Name *

Date of Birth *

NDIS Number *

Address *

Phone *

Email

2. Agreement Period ▼

Agreement Start Date *

Agreement End Date *

Note: typically aligns with NDIS Plan dates

NDIS Plan Start Date

NDIS Plan End Date

3. Services to be Provided ▼

The Provider agrees to deliver the following supports and services:

Total Estimated Monthly Cost: $0.00

Service Delivery Details

Primary Service Location

Participant's home Community Abilitive premises Online/Telehealth Other (specify)

Service Delivery Days/Times

Preferred Support Worker (if any)

Any specific requirements

4. Participant's Goals ▼

The services will support the participant to achieve the following goals:

Short-term Goals (3-6 months)

Long-term Goals (6-12 months)

These goals will be reviewed during regular support planning meetings.

5. Costs and Payment ▼

Plan Management Type *

Self-Managed Plan Managed NDIA Managed Mixed Management

Plan Manager Details

Plan Manager Name

Plan Manager Organisation

Plan Manager Phone

Plan Manager Email

Pricing

All services will be charged in accordance with the current NDIS Price Guide
Pricing is subject to change in line with NDIS Price Guide updates
Any price increases will be communicated in writing at least 30 days in advance

Invoicing and Payment

Invoices will be issued

Payment is due within

Cancellations

Notice required for cancellation

Late cancellation fee

6. Terms and Conditions ▼

Abilitive Pty Ltd agrees to:

Provide services in accordance with this agreement and NDIS legislative requirements
Ensure support workers are appropriately qualified and trained
Maintain professional standards and codes of conduct
Respect the participant's rights, dignity, and autonomy
Provide safe and accessible services
Respond promptly to concerns and complaints

7. As The Participant ▼

You agree to:

• Treat support workers with respect and courtesy
• Provide accurate information about your needs and goals
• Communicate any concerns or changes in circumstances
• Provide reasonable access to your home or agreed location
• Follow agreed service delivery arrangements
• Work collaboratively with Abilitive staff

8. Privacy And Confidentiality ▼

Abilitive Pty Ltd is committed to protecting your personal information in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles. All information collected will be used only for service delivery purposes.

9. Complaints And Feedback ▼

If you have a complaint or concern:

• Contact us on 0421 420 838 or admin@abilitive.com.au
• We aim to resolve concerns within 10 business days
• You have the right to lodge a complaint with the NDIS Commission

10. Service Termination ▼

We will only end services in exceptional circumstances:

• Mutual written agreement by both parties
• Breach of terms of this agreement
• Changes to the participant's NDIS plan
• Safety concerns that cannot be resolved

Notice of Termination:

We will provide at least 14 days written notice and assist you to transition to another provider.

11. Acknowledgement ▼

I acknowledge that I have read and understood this Service Agreement

I confirm that I agree to the terms and conditions outlined in this agreement

12. Signatures ▼

Participant/Nominee Signature

Signature (if applicable)

Date

Abilitive Authorised Officer

Name

Date

Company Stamp