This agreement is made between NAPA Centre Pty Ltd and the below client and representative parent/guardian for the purposes of providing therapeutic supports. Supports are defined as any assessment, training, therapeutic intervention, reports or equipment scripting or any other services provided to the below by NAPA Centre Pty Ltd. The agreement commences from the listed agreement start date and will remain in effect until the listed agreement end date or until either party requires the listed party to be reviewed or terminated. NAPA may review and amend these terms and conditions at any time and in doing so, will advise the below parties of any changes. 

NAPA Centre provides therapy services for children with developmental, neurological, sensory, behavioural,cognitive, orthopaedic, and other types of disabilities. Our programs may include a range of therapeutic techniques and use of equipment, such as: Physiotherapy, Occupational Therapy, Speech and Feeding therapy, NeuroSuit, DMI, Neuromuscular re-education (e.g. TASES), VitalStim, Vibration plate, Treadmills and other exercise equipment, Sensory integration tools and the SpiderCage system.

Potential Risks
While our team takes all reasonable steps to ensure safety, there are risks associated with physical activity and
therapy, including:
• Temporary discomfort or soreness
• Aggravation of existing symptoms
• Muscle strains or, in rare cases, fractures
These risks are minimised through close supervision, safety protocols, and trained therapists, but they can
never be completely eliminated.

Your Responsibilities
As a parent or guardian, you agree to:
• Inform NAPA of any relevant new medical information about your child
• Provide documentation (e.g., bone density scans, hip/spine status, medical clearance) when requested
• If your child has a medical condition such as seizures, asthma, or anaphylaxis, we require a current and complete management plan. You may provide one from your healthcare provider or complete a NAPA-provided form. Our team will rely on this plan in managing any incidents on site. Please keep it up to date.
• Understand that failure to provide required information may result in delays, changes to therapy plans, or a decision to postpone or discontinue therapy.

Voluntary Participation
Participation in therapy is completely voluntary. You have the right to:
• Ask questions about your child’s therapy
• Decline or stop participation at any time (cancellation fees may apply depending on circumstances)
• Be informed about other available options or treatments

Consent to Treatment
By signing this form:
• You confirm that you have read and understood the information provided
• You acknowledge the potential risks associated with therapy
• You give consent for your child to participate in therapy sessions, assessments, and therapeutic activities as recommended by NAPA staff
• You understand that no specific outcomes or guarantees of improvement can be promised

At NAPA Centre, we occasionally take photographs, videos, and audio recordings of therapy sessions for the
following purposes:
• Internal training and staff development
• Assessment and monitoring of therapeutic progress
• Educational presentations and clinical teaching
• Promotional materials, such as websites, brochures, and social media posts
• Research and quality improvement initiatives
These materials may include recordings of your child participating in therapy sessions or interacting with staff.

Confidentiality and Privacy
• NAPA will take reasonable steps to protect your child’s identity and privacy.
• Identifying details (e.g., name, face, voice) will only be shared publicly with your explicit consent.
• We comply with applicable privacy laws and ethical standards to safeguard this information.

Duration of Use and Right to Withdraw
• Your consent remains valid unless and until revoked in writing.
• Withdrawal will not affect materials already in use but will prevent further use of recordings.
• Your decision to provide or withhold consent will not affect the care or services your child receives.

No Compensation
• You acknowledge that you will not receive financial compensation for the use of these materials.

Please carefully review the above terms before providing your consent:

IN CASE OF EMERGENCY:

If additional medical information if required for the patient or in case of emergency, NAPA Centre will first contact the primary listed parent(s)/guardian followed by the additional contacts provided. If the parent(s)/guardian(s) cannot be reached, NAPA can contact the following contacts, whomever can be reached first. If we cannot contact any of the listed contacts, we may call an ambulance if immediate medical attention is required.

At NAPA Centre, we are committed to protecting your privacy and ensuring your child’s health information is managed in accordance with applicable privacy legislation. This consent form outlines how we collect, use, and disclose personal health information, and what your rights are.

Purpose of Collection, Use & Communication
NAPA may use the information you provide to:
• Administer accounts and process payments
• Communicate with you about your child’s treatment and provide information on services, benefits,
and relevant updates
• Notify you about promotions or events
• Send appointment reminders and clinic updates
• Share newsletters, surveys, or conduct market research to improve services
If you do not wish to receive marketing or non-clinical communications, please inform our admin team or use
the ‘unsubscribe’ options provided in messages.

Use and Disclosure for Treatment and Operations
NAPA Centre will use and disclose your child’s protected health information for:
• Treatment purposes
• Payment and billing activities
• Health care operations, including quality assurance and clinical audits
• Staff training and internal administration
Only authorised NAPA staff members may access or use this information when necessary to carry out their professional duties.

Disclosure to External Parties Involved in Your Child’s Care
With your consent, NAPA may share relevant health information with external parties who are involved in your child’s care, provided they have been introduced or approved by you. This may include:
• Equipment suppliers or assistive technology providers
• Other therapists, clinicians, or health professionals
• Educators, support coordinators, or school personnel
• Case managers or allied service providers
Information will only be shared as necessary to coordinate care, support therapy recommendations, or deliver appropriate services and support. If there are specific people or organisations that you do NOT want us to
share any information with, then please let a member of our admin team know.

Your Privacy Rights
• You may access and request correction of your child’s health information at any time.
• You may revoke this consent at any time by providing written notice to NAPA Centre. Revocation will not affect information already shared under this consent.
• A copy of our full Privacy Policy is available on the NAPA website at any time and includes more details about how we manage personal health information. We encourage you to read it carefully.

Consent and Acknowledgment
By signing this form, you:
• Confirm that you have read and understood this consent
• Agree to the use and disclosure of your child’s health information as described
• Authorise NAPA Centre to communicate with nominated or introduced third parties involved in your
child’s careAcknowledge your right to withdraw consent at any time

This policy outlines the terms of financial responsibility for services delivered by NAPA Centre. Services include standard therapy services but may also include: Missed or late-cancelled appointments (as per the Payments
and Cancellation Policy), Phone consultations, Clinical documentation (e.g. evaluations, goal setting, reports), resource preparation and Travel time and travel charges (kilometres). All fees are detailed in NAPA’s Schedule of Fees, available on request in clinic or on our website.

Payment Responsibility
The designated Parent/Guardian is responsible for full payment of all charges for services provided by NAPA Centre. If another individual (such as a co-parent or legal guardian) will be covering costs, it is your responsibility to ensure they are aware of and accept this policy.

Third-Party Funding
If a third party (such as the NDIA, Plan Manager, insurer, or charity) is paying on your behalf, you must provide full contact details and authorise NAPA Centre to liaise with them for payment purposes. If the third party fails to pay or you have insufficient funding for services, full financial responsibility returns to the designated Parent/Guardian. It is your responsibility to ensure there is sufficient funding available for services at the times at which they fall due.

Overdue Accounts and Non-payments
Payment terms must be followed in accordance with our Payments Policy. Accounts that remain overdue for more than 7 days may result in suspension of all services or future bookings until overdue amounts are paid. In the event of non-payment, NAPA may take legal or collection action. You will be responsible for any Legal or administrative fees incurred, potential late fees and recovery costs and any potential impact on your credit rating or implications with the NDIS. Continued late or non-payment will result in termination of services.

Responsibility for Minors
Parents or legal guardians are financially responsible for services provided to minors. If parents are divorced or separated, both parties remain responsible, unless a legal agreement explicitly states otherwise and is provided to NAPA in writing.

By signing below, I acknowledge that I have read and agree to the above Terms and Conditions

We ask all families to review and respect the following guidelines to help us maintain a safe, supportive, and professional clinic environment.

Respect & Behaviour: NAPA Centre is a place of care, respect, and positivity. We expect all clients and visitors to treat our team and other families with kindness and courtesy at all times. Disrespectful or inappropriate
behaviour may result in suspension or cancellation of services. If you have concerns or feedback about a therapist or service, please raise them directly with our team via the communication channels listed below.

Clinic Attendance & Visitors: A parent or carer must remain onsite during their child’s therapy session. While siblings and other family members are welcome, they must be supervised at all times. For safety reasons
children not receiving therapy should not play with therapy equipment or enter the therapy floor unless invited by a therapist. If any visitors disrupt the clinic environment or therapy, they may be asked to step out
of the immediate area.

Illness and Health Precautions: To protect our clients and staff please do not attend the clinic if your child (or you) are unwell. If illness is suspected, NAPA may require the use of a mask, offer a telehealth alternative, or reschedule the session. Please refer to our current illness policy for full details.

Session Safety and Assistance: Your child’s safety is a priority. Some therapy activities may require assistance with lifting or transitions. If a second therapist or therapy aide is unavailable, we may request your assistance.
If you’re unable to be in the session, please let us know in advance so we can adjust our plan. Where consistent or intensive assistance is required, additional fees may apply. We will discuss this with you in advance, where relevant.

Therapeutic Modalities: Our therapists may use a variety of evidence-informed modalities including Manual therapy, Gait and balance training, Electrical stimulation, Sensory integration and more. Some interventions
may not be suitable for all clients. Please inform us of any relevant health concerns or contraindications so we can tailor your child’s care appropriately.

Mandatory Reporting: NAPA therapists are mandatory reporters under relevant child protection legislation. This means they are legally required to report any concerns relating to the safety or wellbeing of a child—even
without parental consent—if there is a risk of harm.

Filming & Photography: If filming or taking photos in the clinic you should only film your own child and make all efforts to not include other children or staff unless you have their express permission, especially if planning
to share your content with others. NAPA may ask you to stop filming if it becomes excessive, disruptive or compromises privacy.

Teaching Environment: NAPA Centre is a teaching and learning facility. Students or trainee therapists may observe or assist in sessions under the direct supervision of qualified therapists. They will never deliver care independently until deemed competent.

Change of Therapist: Occasionally, changes in therapist assignment may occur due to leave, scheduling conflicts, or staffing adjustments. We strive to provide advance notice and will always ensure continuity of care and a professional handover.

Feedback: Your feedback helps us improve. You can provide feedback by contacting us directly, emailing feedback@napacentre.com.au, or arranging a meeting with our management team. You may also submit feedback to the NDIA as outlined in our service agreement or via our website.

By signing below, you confirm that you have read, understood, and agree to the Clinic Guidelines.