Service agreement

Thank you for choosing SDN. We look forward to working with you, your child and other team members to help your child meet their goals.

This online form provides you with essential information that will assist us to provide the best possible care for your child. The information we collect on this form forms a service agreement with you. A summary of our fee schedule can be found at the bottom of this page.

This form outlines some important information about the terms and conditions families ask us about, or that we feel are the most important for your to be aware of. You can find our full terms and conditions here ‘About your Service Agreement’ and well as information about our key ‘Children’s Therapies Policies ’ You can find detailed policies including privacy, complaints management, child protection, fee charging as well as incident and emergency management here.

If you have any questions or need support to complete this form please contact our Family Engagement Team on 1300831445.

About you and your child

Child first name *

Child last name *

Child's date of birth *

Address *

Postcode *

Carer first name *

Carer last name *

Phone number *

Email address *

Preferred method of contact *

Phone

SMS

Emergency contact first name *

Emergency contact last name *

Emergency contact phone number *

NDIS details

Are you receiving NDIS funding for your child? *

Yes

By clicking submit you agree to SDN's terms and conditions as specified in the about your service agreement document.

question *

Please fill out all required fields (*)

Schedule of fees

Therapy session, we will charge the duration of the session plus client notes. Includes face to face in clinic or home, school and/or Early Childhood visits, telehealth sessions (45 mins therapy and 15 mins notes unless discussed prior)	$193.99 per hour
Individual Family Consultation with parents (up to 1.5 hours)	$193.99 per hour
Report writing (will be discussed prior to report being written)	$193.99 per hour
Travel to and from your appointment (if relevant, maximum 30 mins each way)	$193.99 per hour
Consultations with other professionals in supporting your child’s goals (charged per person)	$193.99 per hour
Phone calls and emails directly related to your child’s NDIS Goals	$193.99 per hour
Behavioural therapy (7 years and over) and psychology	$214.41 per hour
Additional resources and tasks	To be discussed with your practitioner

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