Service Agreement

• I understand that all referral and funding documentation must be provided to my clinician on or before appointment dates in order to obtain funding / rebates. This includes re-referrals or updated plans with current clinicians; • I understand and agree to the fee schedule, and that fees are subject to an annual increase on July 1st of each year; • I understand that if my third-party funding is not available, I am required to pay for services; • I understand that prompt payment of invoices will ensure ongoing therapy service provision. I agree to the Talking Works' policy for settling accounts.

o Payment due on or before date of your appointment; o If off site, text or email office your bank deposit receipt to confirm payment; o Full payment is required prior to receiving assessment reports; o Late Payment Fee of $5 applies for payments not made on the day; o Payment options: EFTPOS/Credit Card, Bank Transfer/Deposit; o Mobile & Telehealth sessions require secured credit card details to ensure payment.

o Late Cancellation Fee (less than 48 hours notice): 50% of full fee + GST o Less than 24 hours notice or Non-Attendance: Full session fee + GST ▪ Please note that Cancellation Fee will be waived if appointment filled; ▪ Alternatively, clinicians can provide a telephone consult, letter, or email during the time of your scheduled appointment; ▪ Cancellations are not eligible for Medicare or insurance rebates.

Yes