Consent Form 

I understand that it is mandatory for Parental/Guardian consent for a person under 18 years old or a person above 18 years old with a diagnosed disability and a legally appointed Guardian to receive services from Inspire Allied Health and Education Group and agree to the terms outlined in the consent form on behalf of the participant. Any Participant above 18 years old without an appointed legally Guardian can sign this consent form as the Participant. For the purpose of this consent form, the person that you are giving consent on behalf of will be referred to as the ‘Participant’. You will be referred to as the ‘Parent / Guardian’.

I the Participant understands and consents to having read the Inspire Allied Health and Education Group Participant Guide booklet and Supplement Guides (e.g., Therapy Assistants, Inspire Star Kids, Community Access, Inspire Experience Groups) which are used in conjunction with this consent form and contain valuable information relating to services, providers, attendance, cancellation, fees etc.). I the Participant also agree to reading the revised version of the booklets for updates. I the Participant am aware that the most current version of these booklets overrides all previous versions. Updates on these booklets will be sent to me the Participant via email and it is my responsibility to ensure that Inspire Allied Health and Education Group has my current email address on file.

1.Assumption of Risk

I the Participant understand that interacting with equipment in sessions or sensory space activities may involve risks, including but not limited to physical exertion, potential contact with equipment, and the possibility of injury. I the Participant voluntarily assume all risks associated with these activities and acknowledge that Inspire Allied Health and Education Group, its employees, and representatives shall not be held liable for any injuries, accidents, or damage incurred to myself/Participant.

2.Personal Responsibility

I/The Participant agree to comply with all rules, guidelines, and instructions provided by Inspire Allied Health and Education Group regarding the use of equipment and resources in the therapy setting and sensory space. I acknowledge that it is my responsibility to ensure that I/the Participant can participate in the activities and with the equipment provided. I will inform Inspire Allied Health and Education Group in advance if I / the Participant have any medical or physical limitation that impact on participation.

3.Release and Waiver

In consideration of being permitted to participate in the sensory room activities or to use equipment in therapy sessions, I hereby release, waive, discharge, and hold harmless Inspire Allied Health and Education Group, its owners, employees, and representatives from any and all claims, liabilities, actions, demands, expenses, or damages arising out of or in connection with my/the Participant's participation.

4.Medical Emergencies

In the event of a medical emergency or injury during my/the Participant's participation in the sensory room or during therapy session activities, I authorise Inspire Allied Health and Education Group and its representatives to seek medical assistance on my behalf and to administer necessary first aid. I understand that Inspire Allied Health and Education Group will not be responsible for any costs associated with medical treatment or transportation.

5. Risk Assessments

I understand that all Participants are required to undergo a risk assessment at the commencement of services. I further agree to adhering to the controls put in place on my/the Participant's risk assessment that may include a Parent / Guardian being in the room for the duration of the session. I understand that risk assessment controls are generally put in place to prevent medical and behavioural emergencies.

I acknowledge and understand that all staff members at Inspire Allied Health and Education Group are designated as mandatory reporters. As mandatory reporters, they are obligated by law to report any current or past perceived risk of harm to oneself or others. I am aware that, in accordance with legal obligations, my / the Participant's information may be disclosed without my/the Participant's consent.

I agree to informing an administration staff member if I / the Participant witness or incur a hazard, injury or incident.

I, hereby provide consent for Inspire Allied Health and Education Group to collect and use personal information relating to myself/the Participant for the primary purpose of providing quality services. I understand that the information will be used for:

• Assessment, diagnostic, and support purposes

• Administrative purposes

• Billing directly to me or through a third-party agency

• Disclosure to other professionals or services involved in my/the Participant's management, such as doctors, teachers, insurers, solicitors, employers, only with consent or when legally obligate

• Team collaboration between team members at Inspire Allied Health and Education Group

I understand that my/the Participant's information will be stored on a computerised system for 7 years, and afterward, it will be stored on a password-protected storage cloud. I can request information from the archives for up to 7 years after ceasing services. Destruction and disposal systems are in place for confidential information. Inspire Allied Health and Education Group has a Privacy Act Policy available on request.

I understand that photographs, videos, and audio recordings of myself / the Participant may be taken/requested for therapy resources and kept in the my/the Participants file. I have the right to refuse this if I wish.

I understand that a team member of Inspire Allied Health and Education Group will obtain additional consent for any information collected to be used in ways other than outlined above.

I acknowledge and understand my rights as a client to advocate for my/the Participant's needs, preferences, and concerns throughout the duration of the services provided by Inspire Allied Health and Education Group. Advocacy details can be found in the Inspire Allied Health and Education Group’s Participant Guide booklet.

I acknowledge that Inspire Allied Health and Education Group have a diverse and dedicated team that will be involved in providing services to the Participant. These people comprise of:

• Chief management team

• Executive team

• Registered and certified clinicians (speech and language pathologists, occupational therapists, music therapists, psychologists, art therapists)

• Therapy assistants

• Educators

• Music educators (teachers)

• Administration team members

• Students (education, medical and allied health)

• Graphic designer

• IT support

I acknowledge that all team members maintain current registration, certification, working with children checks, national police clearances, first aid certificates, and NDIS worker screening. Furthermore, our staff undergo extensive training in child protection, and they have completed the necessary NDIS training modules.

I consent to / the Participant receiving support services offered by Inspire Allied Health and Education Group. I am aware that I can find an outline of these services in the Inspire Allied Health and Education Group Participant Guide booklet and supplementary guides along with associated fees, attendance, and cancellation policies. These services may include but are not limited to:

• Assessment

• 1:1 in clinic therapy support

• Community access (preschool, school, home and wider community)

• Telehealth

• Home programs

• Sensory inclusion (in clinic rooms or purposely designed spaces)

• Inspire experiences (groups)

• Inspire Star Kids (intensive transdisciplinary support)

• Multidisciplinary support (having two disciplines in the same session)

• Resource development

• Inspire therapy bundles

• Inspire therapy packs

I declare that I have read, understood, and agree to adhering to the attendance and cancellation policy pertaining to the Participants Support Services located within the Inspire Allied Health and Education Group’s Participation Guide.

I further acknowledge that if I/the Participant would like to cease services that I am required to give 2 weeks notice in writing for individual sessions and 4 weeks for groups.

I understand and acknowledge that once support services have been rendered by Inspire Allied Health and Education Group, payments billed or made for those services are non-refundable.

I acknowledge that periodic reviews and reporting is necessary for the continuation of NDIS services and for clinicians to measure therapeutic outcomes. I agree to the participant engaging in an annual 12-month review which will include a standardised assessment or progress report. I am aware that a team member from Inspire Allied Health and Education Group will advise me on this each year along with associated costs.

I am aware of Inspire Allied Health and Education Groups Policy for Payment of Services and have read the Service for Fee Charges and agree to pay these direct and non-direct service fees. I also understand the following:

• All private and self-managed Participants are required to pay for services at the attendance of their appointment or on receipt of the invoice.

• Plan managed Participants will have their invoices sent to their nominated plan manager and payment is due within 7 days of invoice date.

• NDIA managed Participants will be invoiced and processed for payment within 7 days of the invoice date.

I am aware that  if payment is not received within 14 days of the invoice date, that all services provided to me/the Participant may be suspended and if my/the Participant's account remains unresolved for more than 21 days, Inspire Allied Health and Education Group have the right to refer the matter to a collection agency which may impact my credit rating and occur additional costs.

I also understand that it is my responsibility to know my/the Participant's NDIS balance and if Inspire Allied Health and Education Group is unable to claim payments for my/the Participant's service from my/their NDIS plan that I am personally responsible for these payments.

I understand that communication between the Inspire Allied Health and Education Group team and myself is welcome at any time either in person, by phone, or email.

I will communicate respectfully with all Inspire Allied Health and Education Group staff and understand that any rude/violent behaviour may result in the ceasing of services.

I understand that there will be brief feedback at the beginning or conclusion of in clinic or online sessions and if I require a longer/additional conversation that another appointment will need to be scheduled which may incur further fees.

I understand that for sessions where a Parent/ Guardian is not present for feedback and is required, that communication methods will be established in collaboration with the Participant’s clinician.

We welcome feedback including complaints, suggestions, and compliments. Feedback ensures that we deliver services to the highest standard. We recognise, respect, and encourage the rights of people to give feedback.  Participant and Parent / Guardian feedback is welcomed at any point in time by speaking with your clinician, the head of department, or chief management team or through our Participant' and Parent / Guardian feedback form which can be requested at any time. All feedback is passed onto the company’s CEO. Participant's and Parent / Guardian are also welcome to contact the professional boards of the clinicians or the Safeguard Commission.