NDIS Service Agreement & Schedule of Support
Please review the agreement below and complete your participant details to formalize your support arrangement with Freedom Independence Services.
Business information
Business/trading name: Freedom Independence Services ABN: 79 805 495 435 Email: care@freedomcareservices.info Website: www.freedomindepencecare.com.au
Please read the following agreement carefully. This Service Agreement is made in accordance with the National Disability Insurance Scheme (NDIS) guidelines and outlines the expectations and responsibilities of both the participant and Freedom Independence Services.
Participant Details
Please provide your personal and contact information.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mobile Number
Email Address
example@example.com
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Alternative Contact Person (Name & Number)
*
Advocate (if applicable)
Emergency Contact Person (Name & Number)
Provider Details (Freedom Independence Services)
Contact and business information.
Provider Contact Name
Provider Email
example@example.com
Provider Website
Provider Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Provider Postal Address
Provider Alternative Contact Person (Name & Number)
Agreement Details
Please provide NDIS and agreement period details.
Participant’s NDIS Number
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Agreement Start Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Agreement End Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Agreement Terms and Responsibilities
Please review the scope, continuity of supports, responsibilities, fees, payments, cancellations, consent, incidents, feedback, and advocacy information below.
SCOPE
This agreement is designed to support the independence, inclusion, and well-being of people with disability. Freedom Independence Services will provide reasonable and necessary supports, enabling participants to exercise choice and control in their goals and support planning. We are committed to delivering high-quality, innovative services and raising community awareness about disability inclusion.
CONTINUITY OF SUPPORTS
Freedom Independence Services will ensure continuous support for participants. In the event of staff absence, a qualified replacement will be arranged. Alternative arrangements will be discussed and agreed upon with the participant if unavoidable interruptions occur.
RESPONSIBILITIES
Provider Responsibilities
- Respect the participant’s legal and human rights, culture, diversity, values, and beliefs.
- Protect the participant’s privacy and dignity.
- Provide services as outlined in the Support Plan.
- Review supports regularly with the participant.
- Communicate openly and honestly.
- Consult with the participant or their representative about support delivery.
- Listen to feedback and resolve issues promptly.
- Provide information about managing incidents, complaints, or disagreements.
- Give notice if the provider needs to end the agreement.
- Keep clear records of services provided.
- Comply with all relevant laws and regulations.
Participant Responsibilities
- Inform the provider about preferred support delivery.
- Advise the provider of any changes to personal details.
- Treat the provider with courtesy and respect.
- Discuss any concerns about supports with the provider.
- Give notice if unable to attend scheduled appointments.
- Notify the provider if the NDIS plan changes or is suspended.
FEES AND CHARGES
All fees comply with the NDIS price guide and may change in accordance with updates. Participants will be notified in writing of any changes. Prices are GST inclusive and include the cost of providing support.
PAYMENT
Payment terms depend on the funding arrangement:
- Self-Managed: Participant pays invoices within 7 days.
- Nominee Managed: Nominee pays invoices within 7 days.
- NDIA Managed: Provider claims payment from NDIA.
- Plan Managed: Provider claims payment from the registered plan manager.
CANCELLATION
Short-notice cancellations (after 3 pm the day before service) may incur a charge of up to 90% of the agreed price. Cancellations can be made by email, text, or phone call.
PARTICIPANT’S CONSENT
Freedom Independence Services is committed to protecting participant information. Personal information is collected to provide quality services and support. Participants have the right to access their information and request corrections.
INCIDENTS
Freedom Independence Services ensures all participants are safeguarded. Incidents are acknowledged, reported, investigated, and managed according to policy.
FEEDBACK AND COMPLAINTS
Participants can raise complaints or concerns at any time. Formal investigations will be conducted as needed. Contact details for complaints are provided in the Welcome Pack and on our website.
ADVOCACY
Participants have access to advocacy services to protect their rights and interests. For more information, visit the National Disability Advocacy Program website.
Funding Arrangement
Self-Managed
Nominee Managed
NDIA Managed
Plan Managed
Do you consent to the terms and conditions outlined above?
Yes, I consent and agree to the Service Agreement.
No, I do not consent.
Participant or Legal Guardian Signature
*
Participant or Legal Guardian Name
*
First Name
Last Name
Date Signed (Participant or Legal Guardian)
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
2025 Freedom Independence Services. ABN 79 805 495 435
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