• A colourful abstract logo featuring four interlocking heart-like shapes in red, grey, dark blue and light blue, arranged symmetrically around a central point, with a matching coloured circle at the outer end of each shape
  • Service Agreement

    Home Alone Support Services
  • This service agreement has been developed and negotiated in partnership with you and, if requested, your supporter, family member, carer, advocate or other significant person. We will help you to understand the terms of this service agreement and ensure it is written in plain language so that it is readily understandable.

  • Your Details

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • Your classification funding

  • Classification level   Classification 5: ~$40,000
    Quarterly budget       ~$10,000
    Access approval       Attached – Notice of Decision and Support Plan
  • Services to be delivered

  • We will also work with you to determine how, when and by whom the services are delivered to you.
    When you want to access further services, we will... [provider to insert call to action].
  • A colourful abstract logo featuring four interlocking heart-like shapes in red, grey, dark blue and light blue, arranged symmetrically around a central point, with a matching coloured circle at the outer end of each shape
  • Home Alone Support ServicesService Agreement

  • Schedule of Supports

  • Schedule of Supports
    Rows
  • Associated provider Home Alone Support Services
    Address
    Phone 1800 427 700
    Email welcome@homealonesupportservices.com.au

  • When services will start and end

  • Start date*
     - -
  • Our details

  • Reviewing your service agreement

  • We will review this agreement within 12 months on signing or upon your request.

    When reviewing your agreement, we will ensure you have the opportunity to participate in the review. We will give consideration to whether any updates need to be made to this agreement and if necessary, we will vary the service agreement.

  • Varying your service agreement

  • When a variation is needed to this agreement, we will consult with you about the variation and only vary the agreement with your consent. Any variations will need to comply with the Aged Care Act 2024 and A New Tax System (Goods and Services Tax) Act 1999.

    We need to ensure that service agreements are compliant with the A New Tax System (Goods and Services Tax) Act 1999. This means that we may need to vary the agreement to comply. When this occurs, we will provide you with reasonable notice in writing.
  • A colourful abstract logo featuring four interlocking heart-like shapes in red, grey, dark blue and light blue, arranged symmetrically around a central point, with a matching coloured circle at the outer end of each shape
  • Home Alone Support ServicesService Agreement

  • Cancellation of a session

    If you are unable to attend your scheduled support, please provide as much notice as possible. If you are unable to provide 24 hours' notice you will be charged for the full service. Less than 48 hours' notice 50% of the service fee will be charged

    Termination of this service agreement
    You can terminate this agreement if:

    • You notify us in writing that you no longer wish to receive our services, or
    • You notify us in writing that you are moving to a location where we do not deliver services.

    If you wish to stop receiving services, you must contact us in writing via
    welcome@homealonesupportservices.com.au

    We can only terminate this agreement if:

    • You can no longer be cared for in the home or community with the resources available to us, or
    • Your condition changes to the extent that you no longer need our services or an approved needs assessor assesses your needs are more appropriately met through other types of funded aged care services, or
    • You have intentionally caused serious injury to a member of staff or have intentionally infringed the ability of a member of staff to work in a safe environment, or
    • You have not paid any fee or contribution to us, for a reason within your control, and have not negotiated an alternative arrangement for payment of the fee or contribution
    • And we have given you written notice of our intention to cease delivery.

    Cooling off period
    There is a cooling off period where you may withdraw from this agreement. You can withdraw from this agreement anytime within 14 days of signing the agreement, so long as you have not received services from us.

    Where this occurs, the service agreement will have no effect, and we will refund any amount paid to us under the agreement.

    Persons we can contact in relation to your service agreement (your supporter)
    Contact person / registered supporter / guardian

  • Format: (000) 000-0000.
  • A colourful abstract logo featuring four interlocking heart-like shapes in red, grey, dark blue and light blue, arranged symmetrically around a central point, with a matching coloured circle at the outer end of each shape
  • Home Alone Support ServicesService Agreement

  • Authority

  • Date*
     - -
  • Date*
     - -
  •  
  • Should be Empty: