Other Services
Service
Agreement
Trueblue Value Services
Service Agreement
MyNDIS@truebluevalueservices.com
TVS PTY LTD -
T/A TRUEBLUE VALUE SERVICES – www.truebluevalueservices.com
(ABN: 34 093 529 830)
of
(PO BOX 266,HAMPTON PARK VIC 3976)
Provider Service - Plan Management
This Agreement will commence on:
(Date entered Below)
The NDIS and this Agreement This Agreement is made for providing support services under the Participant’s NDIS plan (NDIS Plan). The Parties agree that this Agreement is made in the context of the NDIS, which is a scheme that aims to: • Support the independence and social and economic participation of people with disability; and • Enable people with a disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their support services. • Schedule of support services The Provider agrees to provide the Participant the support services
Add Infomration About the Service you would like from Trueblue Value Services in your own words
FUNDING TO BE USED FROM NDIS NDIS FUNDING from you
CORE CATEGORY in your plan.
NO OUT OF POCKET FEE TO YOU.
As Listed in the Schedule of Services via NDIS Legislation.
03_040000919_0103_1_1
Support Item Name Disability-Related Health Consumables - Low Cost
Consumables are items (goods) that you can purchase when directly related to your Plan Goals , directly related to helping with your disability and that is under $1500.00 -
These items require IN WRITING FROM
OT/ GP/ Specialist/ Physiologist or Psychiatrist/ other Therapists
(Any consumable over $1500.00 you need to chat to us before the process to purchase can begin)
Our Plan Management Department when appropriate will prepay for items that have been advised and we will process a reimbursement for our payment , so you are not out of pocket at all.
(You will need to be a client with our PLAN MANAGEMENT Department before we can offer this service)
National
$1.00 x PRICE OF GOODS (Max $1500)
Remote
$1.00 x PRICE OF GOODS (Max $1500)
Very Remote
$1.00 x PRICE OF GOODS (Max $1500)
Need more info before signing, book in an appointment, click on clink below.
https://www.truebluevalueservices.com/app-appointments
01_060_0115_1_1
STA And Assistance (Inc. Respite)
- 1:1 - Weekday
01_059_0115_1_1
STA And Assistance (Inc. Respite)
- 1:1 - Saturday
01_060_0115_1_1
STA And Assistance (Inc. Respite)
- 1:1 - Sunday
Respite Options - In accordance with NDIA outlines ALL participants are eligible to have a maximum of 28 days of Short Term Accommodation per year.
(You MUST be aware that this funding comes from your CORE funds and not OTHER funding, this means when this funding is used it takes away CORE funds normally used for other daily activities)
National - Weekdays
$1,781.49 PER DAY
Remote
$2,271.17 PER DAY
Very Remote
$2,870.93 PER DAY
Need more info before signing, book in an appointment, click on clink below.
https://www.truebluevalueservices.com/app-appointments
Support OTHER Type of Service OR Support Discussed prior to this Agreement Being Made
Other Services and Supports MAY BE OFFERED Under this Service Agreement from
Trueblue Value Services.
We will have had communication before you signing this Agreement and as you have chosen the "other" selection ABOVE and added a note to type of Service you have agreed to a Service or Support especially offered to you for a fixed period , we will finalize and add ALL THE Full information into the Service Agreement COPY that will be SENT to YOU via EMAIL ,
AFTER you
complete this and sign FORM
Metro
Will Be ADDED to COPY of SERVICE AGREEMENT SENT to YOUR EMAIL
Remote
Will Be ADDED to COPY of SERVICE AGREEMENT SENT to YOUR EMAIL
Very Remote
Will Be ADDED to COPY of SERVICE AGREEMENT SENT to YOUR EMAIL
Need more info before signing, book in an appointment, click on clink below.
https://www.truebluevalueservices.com/app-appointments
If you need more information feel free to contact us directly to discuss
or you can visit :
https://www.ndis.gov.au/providers/pricing-arrangements
("OTHER" refers to services or supports you have agreed to accept from
Trueblue Value Services.
Example can be - My cleaner is Sick or away for 4 weeks and i need a temporary service until they are back - Trueblue Value Services Agreement is for a cleaner for 1 hour per week for 4 weeks only.
IF you have chosen to have an "other" agrement with us , ALL the information will be emailed to you after this form is returned.)
IF AT ANY TIME YOU WISH TO CHANGE OR EXIT THIS SERVICE PLEASE ADVISE US AS SOON AS POSSIBLE IN WRITING
ONCE WE RECEIVE YOUR NOTICE WE WILL BEGIN PROCESS OF EXIT FORM THIS SERVICE AGREEMENT
PLEASE TRY TO NOTIFY US WITHIN 48 HOURS TO AVOID ANY CHARGES BEING MADE AND PAYMENTS BEING PROCESSED
The Provider agrees to:
● Review the provision of Services at least 12-monthly with the Participant;
● Once agreed, provide Services that meet the Participant’s needs at the Participant’s preferred times;
● Communicate openly and
honestly in a timely manner;
● Treat the Participant with
courtesy and respect;
● Consult the Participant on decisions about how Services are provided;
● Give the Participant information about managing any
complaints or disagreements
and details of the provider’s
cancellation policy (if relevant);
● Listen to the Participant’s feedback and resolve problems quickly;
● Give the Participant a minimum of 24 hours’ notice if the Provider has to change a scheduled appointment to provide Services;
● Give the Participant the required notice if the Provider needs to end the Agreement (see ‘Ending this Service Agreement’ below for more information);
● Protect the Participant’s privacy and confidential information;
● Provide Services in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules, and the Australian Consumer Law; keep accurate records on the Services provided to the Participant; and
● Issue regular invoices and statements of the Services delivered to the Participant. Responsibilities of the Participant/Participant’s Representative
The Participant/Participant’s Representative 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 the Provider a minimum of 24 hours’ notice if the Participant cannot make a scheduled appointment; and if the notice is not provided by then, the Provider’s cancellation policy will apply; ● Give the Provider the required notice if the Participant needs to end the Agreement (see ‘Ending this Service Agreement’ below for more information); and
● Let the Provider know immediately if the Participant’s NDIS Plan is suspended or replaced by a new NDIS Plan or the Participant stops being a participant in the NDIS.
Indemnity: We have Insurance For:
The Participant/Participant’s Representative must indemnify and hold the Provider harmless from and against all claims and losses arising from loss, damage, expense, liability, injury to the Participant, by reason of or arising out of the services supplied to the Participant by the Provider within or outside of the scope of this Agreement.
Changes to this Agreement:
If changes to the Services or their delivery are required, the Parties agree to discuss and review this Agreement. The Parties agree that any changes to this Agreement will be in writing, signed, and dated by the Parties. Ending this Agreement Should either Party wish to end this Agreement they must give Minimum 48 Hours NOTICE or charges may still be Processed.
If either Party seriously breaches this Agreement the requirement of notice will be waived.
Feedback, complaints and disputes:
If the Participant wishes to give the Provider feedback, the Participant can talk to Seli Srdanovic on 0482434774
or email MYNDIS@truebluevalueservices.com
If the Participant is not happy with the provision of Services and wishes to make a complaint, the Participant can talk to Seli Srdanovic on 0482434774
or email MYNDIS@truebluevalueservices.com If the Participant is not satisfied or does not want to talk to this person, the Participant can contact the National Disability Insurance Agency by calling 1800 800 110, visiting one of their offices in person, or visiting ndis.gov.au for further information.
Goods and Services Tax (GST) :
For the purposes of GST legislation,
the Parties confirm that:
● a supply of Services under this Agreement is a supply of one or more of the reasonable and necessary Services specified in the statement included, under subsection 33(2) of the National Disability Insurance Scheme Act 2013 (NDIS Act),
in the Participant’s NDIS Plan currently in effect under section 37 of the NDIS Act;
● the Participant’s NDIS Plan is expected to remain in effect during the period the Services are provided; and
● The Participant/Participant’s Representative will immediately notify the Provider if the Participant’s NDIS Plan is replaced by a new Plan or the
Participant stops being a participant in the NDIS.
Participant / Nominee consent:
Note: This form can be completed electronically and should be used in conjunction with the Trueblue Value Services 'Decision making and consent' policy. We collect information about you for the primary purpose of providing quality supports and services to you. We need to collect some personal information from you to ensure our services meet your needs. If you do not provide this information, we may be unable to fully provide these services.
This information will also be used for:
a. Administrative purposes for running our service
b. Billing you directly, through the NDIS, or other agency if required
c. Use within our service to ensure you are provided with quality supports and services
d. Disclosure of information to the NDIA, the NDIS Quality and Safeguards Commission, or other government agencies if needed
e. Disclosure of information to health professionals to ensure high quality health care for you if needed
f. Disclosure to other providers, with your consent, in order to provide appropriate services.
We do not disclose your personal information to overseas recipients under any circumstance.
We have a privacy policy that is available on request. That policy provides guidelines on the collection, use, disclosure and security of your information. To ensure the process of quality supports and services, information about you may be given to other service providers who also provide you services.
I have Understood , Consent and Agree to :
• Have read the above information and understand the reasons for the collection of my personal information and the ways in which the information may be used and disclosed and I agree to that use and disclosure
• Understand that this consent is valid only for the time specified • Understand that it is my choice as to what information I provide and that withholding or falsifying information might act against the best interests of the supports and services I receive
• Am aware that I can access my personal information and shift notes on request and if necessary, correct any information I believe to be inaccurate
• Understand that if, in exceptional circumstances, access is denied for legitimate purposes, that the reasons for this and possible remedies will be made available to me
• Have been provided with or have been given an opportunity to obtain a copy of the privacy policy. I consent to provide my personal information to :
Trueblue Value Services
Other Services
Service Agreement
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Personal information
collection statement :
Personal information collection statement You may contact us by email, mail or phone using the details provided at the bottom of this page. You have the right to gain access to the information we hold about you. Our privacy policy (available upon request) contains information on how you may request access to, and correction of, your personal information and how you may complain about a breach of your privacy and how we will deal with such a complaint. We need to collect information about you for the primary purpose of providing quality supports and services. In order to fully provide these services, we need to collect some personal information from you. This information will also be used for the administrative purposes of running the practice such as billing you or through the NDIS. Information will be used within the service for planning and managing your plans and supports. We may disclose information regarding you to other service providers or health professionals only with your consent. We will not disclose your information to commercial companies, however specific service or product information as deemed suitable for your management, may be forwarded to you by us, unless you instruct us not to forward this type of information. Your written consent will obtained at the start of any new planned activities. We do not disclose your personal information to overseas recipients.
Digital information
collection & storage statement :
File information is stored securely and access only by our workers. We take all reasonable steps to ensure that information collected about you is accurate, complete and up-to-date. You may have access to your information on request and if you believe that any of the information is inaccurate, we may amend it accordingly. If you do not provide relevant personal information, in part or in full, this may result in the provision of incomplete supports or services which may impact on your plans and goals. Any concerns you may have about this statement or the information we store about you can be directed to :
MYNDIS@truebluevalueservices.com
