Berkman Academy NDIS Service Agreement Logo
  • Berkman Academy

    NDIS Service Agreement
  • This Service Agreement is made for the purpose of providing supports under the participant’s National Disability Insurance Scheme (NDIS) plan.

    The parties agree that this Service Agreement is made in the context of the NDIS, which aims to:

    • Support the independence, wellbeing, and social and economic participation of people with a disability.
    • Enable people with a disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports.
  •  - -
  • Between:

  • AND

  • Berkman Academy 271 Bayswater Road, Bayswater North (VIC)

    (ABN 8632 5566 918) (“the Organization")

    The Organization hereby agrees to carry out and/or provide the Supports for the Participant in accordance with the Schedules and the Terms attached to this Agreement.

  •  - -
  •  - -
  •  - -
  • Price & Payment Information

  • Equine assisted therapy sessions are $156.16 per session as agreed

    Innovative community participation sessions are $156.16 per session as agreed

    Report writing for plan review, case conferencing is $156.16 per hour as agreed

     

    Cancellation Policy

    We understand that at times it is necessary to cancel or change appointment times and we really appreciate as much notice as possible. The full fee is charged in the event of non-attendance or cancellation within 48hrs.

  • Powered by Jotform SignClear
  • Terms and Conditions

  • The Organization agrees to provide or deliver the Supports to the Participant in accordance with Schedules 1 and 2, and the terms and conditions of this Agreement.

    The parties acknowledge that this Agreement is bound by NDIA’s Terms of Business as in force from time to time.


    The parties to this Agreement acknowledge that the Supports in this Agreement are provided to the Participant in the context of the NDIS, which aims to:

    3.1. Support the independence and social and economic participation of people with disability; and

    3.2. Enable people with a disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports.

    Organization’s Responsibilities
    4.1. The Organization agrees to:

    a) Work with the Participant and/or their representative (if applicable) to deliver Supports that meet your needs;

    b) Consult with the Participant when making decisions about how Supports are provided;

    c) Protect the Participant and/or their representative’s privacy and confidential information in compliance with privacy law including the Privacy Act 1988 (Cth);

    d) Deliver the Supports in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 (Cth) and rules, and the Australian Consumer Law;

    e) Keep clear and up-to-date records on the Supports provided to the Participant; and

    f) Issue regular invoices and statements to the Participant describing the Supports that we have provided to the Participant.

  • 5. Participant’s Responsibilities

    5.1. The Participant agrees to:

    a) Work with the Organization to ensure scheduled Supports can be delivered as agreed;

    b) If applicable, provide us with evidence of your authority to act on behalf of the Participant if asked to do so.

    6. Pricing / Additional Expenses

    6.1. Except in relation to transport Supports, the Organization agrees to charge the Participant for the Supports provided according to the maximum recommended price in the NDIS Price Guide or as varied from time to time.

    6.2. The Parties agree and acknowledge that:

    a) The price for transport Supports is charged according to the Schedule of Supports (including a reasonable contribution for the Organization’s transport costs) rather than the NDIS Price Guide;

    b) The NDIS Price Guide is subject to change and the Organization will vary its price for each Support from time to time. If this occurs, the Organization will organize a review with the Participant as soon as practicable.

    6.3. The Participant acknowledges that any additional expenses that are not part of their Support will be their responsibility to pay. If any additional expenses are paid by the Organization, these will be passed on at cost to the Participant.

  • 7. Payment

    7.1. The Organization will invoice the Participant for the Supports provided or delivered by the Organization pursuant to this Agreement according the prices set out in Schedule 1. 

    7.2. The parties agree that whichever of the following clauses 7.3, 7.4, 7.5 and 7.6 is in force is applicable according to the method of payment marked in Schedule 2.

    7.3.Payment by Self-Managed Participants: The Participant must pay to the Organization the amount on the invoice issued by the Organization pursuant to clause 7.1 in the manner and time period specified on the invoice. 

    7.4.Payment by Plan Nominee The Participant will do any and all things to require the Plan Nominee to pay the Organization the invoice issued by the Organization pursuant to clause 7.1 in the manner and time period specified on the invoice.

    7.5.Payment by National Disability Insurance Agency The Organization will seek payment of the invoice issued by the Organization pursuant to clause 7.1 directly from the National Disability Insurance Agency in satisfaction of the Supports provided pursuant to this Agreement.

    7.6.Payment by Registered Plan Management Provider The Participant will do any and all things to require the Registered Plan Management Provider to pay the Organization the invoice issued by the Organization the invoice issued by the Organization pursuant to clause 7.1 in the manner and time period specified on the invoice.

  • 8. Review/Notification

    8.1. The parties agree to use their best endeavors to conduct regular review of this Agreement, or as required due to the Organization’s operational reasons. 

    8.2. The Participants agrees to notify the Organization within 14 days of any of the following changes taking effect: 

    a) The Participant’s NDIS Plan is suspended or cancelled; 

    b) The Participant’s contact details change;

    c) If applicable, the Participant representative’s contact details change;

    d) If applicable, its “Authority to act on behalf of the Participant” is revoked, changed or expires; or

    e) There is a change to the manner or details of the person/organization who will pay invoices for Supports.

    9. Consent

    9.1. The Participant hereby gives consent for the Organization to create and/or approve service bookings for and on behalf of the Participant through the MyPlace Portal in accordance with this Agreement (including the Schedule of Supports).

  • 10. GST

    10.1. All prices (if applicable) in this Agreement are expressed to be inclusive of GST.

    10.2. The parties acknowledge that a supply of Supports under this Service Agreement is a supply of one or more reasonable and necessary supports specified in the Statement of Supports 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.


    11. Cancellation

    11.1. Service Bookings

    a) The parties acknowledge that either party may cancel a Service Booking.

    b) If the Participant cancels a Service Booking, it agrees to give at least 28 days’ written notice to the Organization.

    c) If the Organization cancels a Service Booking, it agrees to discuss it with the Participant first and give at least 28 days’ notice.


    11.2. Scheduled Supports and ‘No Shows’

    a) The Participant must notify the Organization of a cancellation of a scheduled Support in writing, by email or by telephone to the Organization’s contact person.

    b) If the Organization is notified of a cancellation of a scheduled Support:

    i. At least 48 hours in advance, the Participant will not be charged a fee for that cancellation by the Organization;

    ii. Less than 48 hours in advance, the Organization will charge a fee if it is unable to utilise the same scheduled Support for another participant.

    c) The parties acknowledge that the scheduled Support will be charged in full if there has been a “no show” by the Participant or if only part of the scheduled Support has been delivered.

    d) If during a continuous 12-month period, there are more than 8 cancellations or ‘no shows’ by the Participant (or 2 cancellations or ‘no shows’ for therapy related Supports), the Organization may elect to notify the NDIA on the grounds that the Participant’s NDIS Plan may need to be reviewed.


    11.3. Cancellation by Organization

    a) Where the Organization cancels a scheduled Support, it will use its reasonable best endeavours to reschedule the appointment.


    12. Variation/Termination

    12.1. The Parties agree that any variation of this Agreement is not of effect unless it is in writing, signed and dated by the Parties.

    12.2. Either party may end this Agreement by giving at least 28 days’ written notice to the other or such longer time period as reasonably necessary for the Participant to nominate an alternative provider. In the case of termination by the Participant, written notice must be provided to the Organization’s listed Contact Person.


    13. Definitions:

    “NDIA” means the National Disability Insurance Agency;
    “NDIS” means the National Disability Insurance Scheme;
    “NDIS Plan” means an individualized plan that sets out each Participant’s information, goals, supports and budget;
    “NDIS Price Guide” means the price guide for supports which is published by the NDIA from time to time;
    “Plan Nominee” means a person who is approved by the Participant to manage their NDIS funding;
    “Registered Plan Management Provider” means a service provider who is registered with the NDIA and authorized to manage funding for participants;
    “Schedule of Supports” means the table set out in Schedule 1 of this Agreement;
    “Supports” means the support types outlined in Schedule 1 of this Agreement.


    14. Feedback, Complaints and Dispute Resolution

    If the Participant wishes to provide feedback to the Organization, or if the Participant is not happy with the provision of supports and wishes to make a complaint, then it may ask the Organization for a copy of its complaints process. If the Participant is not satisfied with the Organization’s response, 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.

  • Executed as an Agreement

  •  - -
  • Powered by Jotform SignClear
  •  - -
  • Powered by Jotform SignClear
  • General Information
    Berkman Academy provides equine-assisted therapy and counselling services grounded in evidence-based practice. Where clinically appropriate, sessions may include interaction with horses, dogs, and other animals in an outdoor farm setting. This environment carries unique risks not found in traditional clinical settings.

    When working outdoors, clients may be observed by others outside of the therapeutic space. These situations are monitored carefully, and consultation, planning, and management between client and therapist will occur as required.

    Participants must wear suitable outdoor clothing and sturdy, closed-toe shoes. As sessions take place in a farm environment, instructions will be provided regarding safe practices. Please note that electric fences are in use on the property and must not be touched.


    Provider’s Responsibilities
    Berkman Academy promises to:

    Listen to you.
    Be reliable, honest, and respectful.
    Work in partnership with you and other service providers.
    Support you in making decisions with confidence.
    Share accurate and current information with you.
    Be clear about what we can and cannot provide.
    Respond promptly to feedback and resolve issues quickly.
    Provide supports at the agreed time and place.
    Give you at least 48 hours’ notice (where possible) if a scheduled session needs to change.
    Review the provision of supports with you at least every 6 months.
    Keep clear and accurate records of the services provided.
    Provide at least 14 days’ notice of any price changes.
    Issue invoices and statements of the supports delivered in line with NDIS requirements.

    Participant or Representative Responsibilities
    The participant or their representative agrees to:

    Work with Berkman Academy to ensure services and supports meet their needs.
    Treat Berkman Academy staff with courtesy and respect.
    Refrain from bringing dogs or other animals onto the property.
    Communicate with Berkman Academy if there are any concerns about the services provided.
    Give at least 48 hours’ notice when cancelling an appointment. If notice is not provided, Berkman Academy’s cancellation policy will apply and the full session fee will be invoiced.
    Inform Berkman Academy immediately if the participant’s NDIS plan is suspended, replaced, or funding changes.
    Provide accurate and up-to-date information about other services being received where relevant.
    The participant/representative also gives permission for Berkman Academy to provide feedback to a nominated Support Coordinator or primary contact where required to ensure continuity of care. This is in addition to mandatory reporting requirements.


    Confidentiality
    Personal information gathered as part of this service will remain confidential except when:

    It is subpoenaed by a court; or
    Failure to disclose would place the participant or another person at serious risk of harm; or
    Prior approval has been obtained to:
    a) Provide a written report to another professional or agency (e.g., GP, lawyer).
    b) Discuss information with another person (e.g., parent, employer, support worker).
    c) Share information in another agreed way.
    It would be reasonably expected that information is disclosed to another professional or agency (e.g., GP, psychologist) where this is directly related to the care provided.
    Disclosure is otherwise required or authorised by law.
    Mandatory Reporting: As a registered counsellor, Berkman Academy staff are mandated reporters. If there is a reasonable belief that a child or vulnerable person is at risk of harm, Berkman Academy is legally required to report this.

    Record Keeping: Session notes are kept brief, factual, and stored securely in password-protected files. Records are retained for a minimum of 7 years, in line with professional counselling and NDIS standards.


    Photography
    Photographs may be taken during sessions to provide feedback to participants and families. These photos are stored securely and will not be shared without permission. If you do not wish photographs to be taken, please advise your therapist.

    With consent, some photographs may be used for training, education, or Berkman Academy’s social media.


    Claims / Payment
    Berkman Academy will seek payment for services and travel (where relevant) based on the current NDIS Price Guide at the time services are delivered.

    Funding can be managed as:

    Plan-managed – invoices will be sent directly to the nominated Plan Manager.
    Self-managed – invoices will be sent directly to the participant/representative and must be paid within 7 days.
    Berkman Academy is not able to process Agency-managed (NDIA portal) payments.

    All prices are GST inclusive where applicable.

  • Ending this agreement

    This agreement can be cancelled by either you or Berkman Academy. Reasonable notice should be given by either party to ensure all the necessary documentation can be completed and provided to NDIS. 

    If either party seriously breaches this Service Agreement the requirement of notice will be waived. If you wish to end this Agreement prior to the end date, a Transition Report may be required by NDIA which will be charged to your NDIS plan.

  • Agreement Signatures

    All parties agree to the terms or conditions of this agreement
  • Powered by Jotform SignClear
  •  - -
  • Powered by Jotform SignClear
  •  - -
  • Should be Empty: