Plan Management

NDIS Provider Service Agreement

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Date of Trueblue Value Services - Plan Managment Agreement Completion :

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*NEW* - NDIS Service Agreement - I am NEW to Trueblue Value Services

*UPDATE* - NDIS Service Agreement - I am a client already at, Trueblue Value Services - Need to Make Updates

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Do you Have more than 1 Service with Trueblue Value Services Currently?

Services With Trueblue Value Services

Introduction to NDIS Conflict of Interest Disclosure

Welcome to Trueblue Value Services! We're committed to providing you with the highest quality support under the NDIS. As part of this commitment, we want to be transparent about the importance of managing conflicts of interest.

What is a Conflict of Interest?

A conflict of interest arises when there's a risk that a person's individual interests or relationships could influence their professional judgment or actions.
In the NDIS context, this could involve situations where Trueblue Value Services' interests, or yours, might potentially clash with providing the best possible support for your NDIS plan.

Why Disclosure is Important

Transparency: Open communication about potential conflicts helps build trust and ensures everyone is on the same page.
Proactive Management: Identifying conflicts early allows us to take steps to manage them effectively and minimize any negative impact.
Safeguarding Your Interests: It's crucial that the supports and services you receive are chosen based solely on your needs and goals.

Our Commitment

Trueblue Value Services has robust policies and procedures in place to identify, disclose, and manage conflicts of interest.
We're committed to being open and honest with you about any potential conflicts that may arise.
We'll work collaboratively with you to find solutions that protect your interests and ensure you receive the best possible support.

Your Role

We encourage you to be open with us about any concerns you may have regarding potential conflicts of interest.
Your input is valuable in helping us maintain transparency and make informed decisions together.

By working together, we can ensure that conflicts of interest are managed effectively, and that your NDIS journey is focused on achieving your goals.

Thank you for choosing Trueblue Value Services.

Please feel free to reach out if you have any questions about our conflict of interest policy or any other aspect of our services.

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CHECK BOX TO CONTINUE WITH SIGN UP FOR ANOTHER SERVICE *

By Ticking the box above You Agree and Understand :

1. You can end any service with Trueblue Value Services at any time , and this will not effect other services.

2. You Agree and Understand that Trueblue Value Services should never have 1 service impact another service.

3. You Agree and Understnad that Trueblue Value Service treats all service departments as they would if coordinatoing with other external services with full permission from you for all descisions at all times.

4. You Agree and Understand Trueblue Value Services will provider you with all documentation and advise of our polices and your rights for you to referrance and use in the future at any time if you feel there has been any breach or conflict.

Trueblue Value Services - Plan Management

SHOW ME - Provider Information :

NDIS Provider Company Name : CRM/Proda

NDIS Provider Copmany Name : PACE

Trueblue Value Services Austalian Business Number

Trueblue Value Services NDIS Commission Registration No.

NDIS Provider Finder Information :3818 Trueblue Value Services

TVS PTY LTD ABN

NDIS Provider Finder Lookup

NDIS Commission Lookup

Call : Plan Management Team

Call : Manager Direct Line

Email : Plan Management Team

EMAIL : Plan Manager

POSTAL Address : Head Office - NDIS Documents

Contact Us :

Our Company Information

NDIS Participant Information

Please Enter ALL Details As on NDIS Plan

Enter My Information : *

NDIS Participant - First Name : *

NDIS Participant - Middle Name :

Preferred Name :

NDIS Participant - Last Name : *

NDIS Participant - NDIS Number : *

NDIS Participant - Date of Birth (DD/MM/YYYY) *

Participants - Contact Phone Number : *

Participants - Contact Email Address : *

NDIS Participant Address *

Street address *

City

State

Postcode

NDIS Particpant Signiture :

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NDIS Participant Representitive Information - Please Enter ALL Details As on NDIS Plan :

Enter My NDIS Representitives Information :

NDIS Representative - First Name :

NDIS Representative - Middle Name :

NDIS Representative - Last Name :

NDIS Representative - NDIS Number :

NDIS Representative - Date of Birth :

NDIS Representative - Contact Phone Number :

NDIS Representative - Contact Email Address :

NDIS Representative - Address :

Street address

City

State

Postcode

Relationship With NDIS Participant : Please Select

Child Representative - Legal ParentPlan Nominee - Assigned and Approved by NDIS Communications Nominee - Assigned and Approved by NDISNDIS Provider - Care WorkerNDIS Provider - Support Coordinator NDIS - Local Area CoordinatorNDIS - PlannerOther - Please Add More Information Below :

Other Representative Information :

NDIS Representative Signiture :

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NDIS Plan Information :

Enter NDIS Plan Information :

NDIS Current Plan Start Date (DD/MM/YYYY) : *

NDIS Current Plan End Date (DD/MM/YYYY) : *

NDIS Plan Months Left Before Ending :

NDIS Invoice Code - 14_034_0127_8_3 - Plan Management - Monthly Fee

Cost For Rest of Plan - Monthly Fee For This Plan : (Monthly Fee $104.45 Per Month)

NDIS Invoice Code - 14_033_0127_8_3 - Plan Management - Set Up Costs

Cost For - Set Up Fee For This Plan : (Set Up Fee 1 Per New Plan - $235.35)

IF Your Plan Is Under 12 Month Period and You are Transfering Services to Trueblue Value Services

Plan Management - We do not charge a Set-Up Fee - Transffer of your Services IS FREE

Upload Copy of Your Plan :

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EMAIL : COPY of MY NDIS PLAN

Add Additional Plan Managment Services :

NDIS Invoice Code - 01_134_0117_8_1 - Capacity Building and Training in Self-Management and Plan Management (Additional Option - CORE Charge)

IF You would Like to be able to BOOK IN WITH : Our Plan Management Team for Extra Funding Supports and Advice

Please Add a Number of Hour you " MIGHT " Use . We do not charge if not used.*PLEASE NOTE this is a charge from Your CORE Flexible Funding*

Add Hour Many Hours Per 12 Months you would LIKE EXTRA Plan Manager Advice Service :

Approximate Total IF All Hours Entered are Used ($77.00 Per Hour) :

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Join Trueblue / Planability APP Portal :

Yes , I WANT TO Join the Trublue/Planability Plan Management Portal :

Trueblue/Planability APP - Apple

Trueblue/Planability APP - Google Play

Participant Guides

Log Trueblue / Planability

IF You do DOWNLOAD the Trueblue/Planability APP :

*You will need to wait until we have set up on our side to see all your NDIS Plan Information*

Approved Portal Access To :

NO Thanks - I have enough APPs

YES - Set Me Up (Do Not Need to Add Another Details Below)

YES - Set Up My Representative (Do Not Need to Add Another Details Below)

Others' , Who Can Access the Portal ? :

NDIS Support CoordinatorNDIS ProviderNDIS Other Other

Approved Portal Access : Name

Approved Portal Access : Email

Approved Portal Access : Phone

Approved Statements To :

NO Thanks - I will contact Trueblue Value Services for the Infomation

YES - Send to My Representative (Do Not Need to Add Another Details Below)

YES - Send To Me (Do Not Need to Add Another Details Below)

Others' , Who Do we Send Monthly NDIS Plan Funding Statements to ? :

NDIS Support CoordinatorNDIS ProviderNDIS Other Other

Approved to Get Statement : Name

Approved To Get Statement : Email

Approved To Get Statement : Phone

Approve or Reject Invoices :

NO - Just Approval ALL

YES - For Me (Do Not Need to Add Another Details Below)

YES - For My Representative (Do Not Need to Add Another Details Below)

Others' , Who Can Approve Invoices BEFORE Payments are Made ? :

NDIS Support CoordinatorNDIS ProviderNDIS Other Other

Approve or Reject Invoices : Name

Approve or Reject Invoices : Email

Approved or Reject Invoices : Phone

Invitation Emails will be sent only AFTER the Plan Management System is Set-Up

IF you need to update us that you want to remove or change a person from this access , send email to :

payments@truebluevalueservices.com

Add my Bank details for NDIS Reinbursements :

Add my Bank Details :

Make sure ONLY Particpant or Plan Nominee Bank Details are added here :

Bank Account Name :

BSB Number :

Account Number :

Bank Receipt / Remittance Email Address :

Update Bank NDIS

Choose your Communication Style :

My Communication Choice :

Communication Selection :

Only when I ask to be contacted and howEmailText Message / SMSPhone Call - Morning ONLY - 9.00am and 11.00amPhone Call - Evening ONLY - 1.00pm and 4.00pmPhone Call - Weekends ONLYVideo Chat National Relay Service - Hearing ImpairmentsOther - I will let you know the best option for me later.

Contact NDIS

I Agree and Understand all comunication with Trueblue Value Services is recorded and stored for quality and coaching purposes.

Offer your Feedback with our NDIS Audits :

Trueblue Value Services NDIS Audits :

I will say :

Yes, I will talk to your NDIS AuditorNo Thanks, I don't want to speak to any NDIS Auditors

NDIS Audits

EXIT my current Provider :

Trueblue Value Services CAN EXIT me from my current Provider :

Trueblue Value Services can assist with you leaving your current NDIS Plan Manager.

We need their contact infromation to start this process.

I ,

Participant Exiting Current Services : (Name)

With NDIS Number ,

Participant NDIS Number for Exit Request :

And ,

Plan Nominee Exiting Current Services : (Name)

Current Provider Company Name :

Current Provider Contact Person Name :

Current Provider Phone Number :

Current Provider Contact Email :

My Account Number : (If Applies)

Provider Endorsement umber : (If Known)

As Of ,

Date I am Requesting to Exit and Cease Services ,

Requesting to Exit Services , and how to verify with me :

You CAN call me to verify, when you get this notice.You CAN email me to verify, when you get this notice.Do Not Contact me in any way, I will contact NDIA directly to let them know.

Exit and Cease Services in time :

ImmediatlyAs Soon as Possible (Let me know when)I will Exit and Cease Services by Contacting NDIA

By Signing Below you Agree and Understand your Service will now be provided by : TVS PTY LTD

By Signing Below you Agree and Undersand there may be a wait period before : TVS PTY LTD can start work on your behalf

By SIgning Below you Are Requesting all Handover Documentation from service Exited should be sent to : TVS PTY LTD

Particpant Exit Request Signiture :

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Plan Nominee Exit Request SIgniture :

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Emergency Contact :

Add Emergency Contact :

Emergency Contact Name :

Emergency Contact Phone :

Emergency Contact Email :

Other Contacts : (Gp, Providers, Allied Health Professionals, Specialists or others) :

Other NDIS Contacts :

NDIS Contact and Company Name

NDIS Contact and Company Phone

NDIS Contact and Company Email

NDIS/Medical Service Provided

Find a Provider NDIS

Find SDA Provider NDIS

Find Allied Health Professionals NDIS

Find NDIS Office

Offering NDIS Consent to Trueblue Value Services :

NDIS Consent offered to Trueblue Value Services, with this agreement :

Tick BOXES that you DO NOT allow Trueblue Value Services to access from NDIS :

Other Information for No Consent to Trueblue Value Services :

Why do you want us to share your information?

Trueblue Value Services are Approved for my NDIS Share Information and Communication on my behalf for all NDIS work, support and assistance they provide to me.

By Signing Below you Agree and Understand your NDIS Information Consent to : TVS PTY LTD

By Signing Below you Agree and Undersand : TVS PTY LTD can see your NDIS Information

Particpant NDIS Consent Signiture :

Clear

Representitive NDIS Consent Signiture :

Clear

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