NDIS Service agreement

Once this NDIS Service Agreement is filled out, we’ll process your order and reach out to you within three business days. For further inquiries, email us at sales@safelife.com.au

Email

Please enter email again below for validation

Confirm Email

Agreement is for: (Insert participant’s full name)

Agreement is for: (Insert participant's full name)

First

Last

NDIS Number

Participant’s Date of Birth (DOB):

This agreement is between Alerting Devices Australia PTY LTD and: (Participant’s name or representative)

Terms of Agreement

This agreement starts on today’s date and lasts for 12 months.

You’re ordering items from our quote/invoice:

Total cost, including shipping

Plan Management – Choose from dropdown

Budget Category (Choose from dropdown)

Confirmation

Confirm that your chosen resources are necessary, related to the participant’s disability, and beneficial.

Yes

No

Optionally, you can give consent for a Safe-Life representative to view your plan online to help process this application/service agreement.

I consent

I do not consent

Contact Details

Participant or Participant’s representative contact information:

Contact Person

First

Last

Participant’s Email

Confirm Participant’s Email

Contact Phone Number

Address

City

State/Territory

Postcode

Goods and Services Tax (GST)

Most NDIS services exclude GST, but some services, like shipping, will include GST. The service provider is responsible for checking whether GST applies and will confirm this upon signing the agreement.

Feedback and Complaints

We aim to provide top-notch service. However, if you encounter any issues, you can email us, or call (03) 9588 0392. If the issue remains unresolved, you can contact the NDIS Quality and Safeguards Commission at 1800 035 544 (free call from landlines) or TTY 133 677. Interpreters and National Relay Service can Contact Phone Number be arranged.

Agreement

By signing, you agree to the terms and conditions of this Service Agreement. Please indicate your agreement or disagreement.

NDIS Service Agreement