Service Provider Registration Form

Service Provider Registration Form

Thank you for your interest in becoming a registered Service Provider with allcare, or renewing your service provider status. Please complete the form below and a member of our accounts team will be in contact with you to confirm receipt, and advise of any further action that must be taken.
View our Service Provider Terms and Conditions

This form is accompanied by our Service Provider Terms and Conditions. By submitting this form, you agree to be bound by the terms of our Service Provider Terms and Conditions.
You can access our Service Provider Terms and Conditions by visiting the following URL.

View Our Terms and Conditions

Section 1: Your Details

In this section we are collecting information about your organisational name, legal entity status and your contact information.
Business Name*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Contact Name*

First NameLast Name
Australian Business Number (ABN)*
Account Contact Phone*
Please enter a valid phone number.Format: 0000 000 000.
Account Contact Email*
example@example.com

Section 3: Fees you will charge

If the services you intend to provide are on an hourly basis, we will request this information from you. If the services are on a quotation only basis (e.g. home modifications and/or maintenance) then please indicate that in this section and you will not be required to indicate an hourly rate.
Do you intend to charge for the services you will provide on an hourly basis?*

YesNo
If you are intending to charge for the services you will provide on an hourly basis, please outline your hourly rates below. Please outline your weekday rate, and weekend rate(s) if applicable: *
Will you provide a quotation for each service that you provide? *

YesNo
Do you agree that you will not provide services to allcare clients until each quotation is agreed in writing? *

YesNo

Section 4: Cancellation charges

If you are intending to charge for the cancellation of services, we are required to collect this information from you. Please note that every effort is made to provide as much advance notice to Service Providers, where allcare is made aware of a client's intent to cancel a requested service.
I agree to only charge for one hour of services as the maximum cancellation rate, unless explicitly agreed with allcare in writing? *

YesNo

Section 5: Documents

We are required to collect a series of documents from you for compliance purposes. Please note that the documents you need to provide are dependent on your organisational type. Please also note that the document you provide will be manually reviewed.
Document 1: Public Liability Insurance - Certificate of Currency*

Cancelof
Document 2: National Police Check (Primary Account Contact)*

Cancelof
Document 3: Workers Compensation Insurance - Certificate of Currency (Does not apply to sole traders)

Cancelof

Section 6: Terms and Conditions

You are required to formally acknowledge that you agree to be bound by our Service Provider Terms and Conditions.
Do you agree to the terms and conditions outlined in the Service Agreement?*

I agree
Should be Empty:

View our Service Provider Terms and Conditions