Fee Schedule Consent Form

There is no contract where you are ‘locked-in’ to a certain time frame; however, we do ask that where possible the parent/guardian give at least 1 week’s notice if the child will be terminating our services. If we feel we can no longer offer the child our services, we will advise you with as much notice as possible.

Some children engage in short-term intervention (6-8 weeks) and others may engage in our services for several years. However, we do ask that you keep communication open around the length of time you think the child will be engaged in therapy/support sessions if you know in advance. This supports us in communicating with the child during our sessions about how many we have left to prepare them for change. Notice of ending therapy/services also allows us to advise other clients on our waitlist how long we think they may be waiting for a booking with us.

Cancellation:

You acknowledge that you are aware that if the child is unable to attend their session, you will need to inform the business as early as possible, or you will still be required to pay a fee. A text is sent to the parent/guardian's mobile number on file 24 hours in advance for them to confirm the booking.

Cancellations made with less than 48 hours notice will incur a cancellation fee of 90% of the relevant fee for the Appointment.

Payment:

When commencing with us for ongoing appointments and bookings, we require 1 session to be paid for in advance. We require subsequent bookings to be paid for before the child attends any additional sessions or within 5 business days of you receiving our invoice. If you have any queries about our fees or any of the charges listed on your invoice, please email: accounts@playtherapytas.com.au (Alternate payment terms exist for NDIS and Agency Funded Clients, please enquire with our accounts department if you require further information).

Authorised Services to be Billed:

Please indicate below which of the following services/items you authorise Playtonomy Pty Ltd to provide and/or invoice you / the relevant agency and/or the relevant plan manager for:

Authorised services for billing

Reports

Assessments

Summary or Support Letters

Care Team Meetings

Provider Meetings

Documentation

Travel

Therapy/Counselling

Activity Packs

Plans (reviewed every 6 weeks)

Online Workshops

Professional or Clinical Recommendations

Referrals

Progress Sessions & Parent Consultations

Behavioural Support Plans

Transition to School Statement

I have read the Playtonomy Pty Ltd Service Agreement, which confirms the details provided above, and I agree to the Terms of Engagement, Cancellation Policy, Payment Terms & Authorised Services to be Billed, as outlined in this Fee Schedule Consent Form.

Relationship to the Child

Signature

(parent/guardian/authorised representative’s signature)

Please indicate below which funding stream the child falls under:

Agency Funded Services: (i.e. Child Safety Services)

NDIS Funded Services: (i.e. NDIS Participants)

Private Fee-Paying: (i.e. self-funded)

Playtonomy Pty Ltd Fee Schedule:

(Current as of October 2024, but prices are subject to change).

Intake Session (inclusive of Therapeutic Plan if required):

These sessions are typically 60 to 120 minutes: $193.99 -$240.00 (inclusive of GSTwhere applicable).

Parent Consultation – (via phone or in person):

Up to $193.99 (inclusive of GST where applicable).

Ongoing Progress & Parent Support Sessions (via phone or in person):

$193.99*

Meeting with parent/caregiver via phone or in person (inclusive of GST where applicable).

*If parent/guardian requests a clinical summary report or notes to be documented and provided at these sessions, these will have an additional fee applied of up to $120.00*.

Individual or Sibling Sessions - Play, Art or Developmental Sessions:

1-hour Play Therapy session (45-minute therapy session and 15 minutes for clinical notes.) Pricing up to $193.99 (inclusive of GST if applicable). *Pricing may vary for the individual needs of the clients and their capacity to engage financial support to access therapy. If you are concerned about your ability to make payments, please discuss this with our accounts manager directly*.

Child/Parent Counselling Sessions:

1-hour Child/Parent Counselling session (45-minute counselling session and 15 minutes for clinical notes.) Pricing up to $156.16 (inclusive of GST if applicable).

Theraplay:

Up to $275.00 per session (inclusive of GST where applicable).

Occupational Therapy:

Hourly Rate: $193.99 for all sessions/clients.

Additional costs or requests:

NDIA / NDIS Reports: $193.99 (per hour of work completed)

Support Letters and Recommendations: $132.00 (inclusive of GST if applicable)

Therapeutic Response Plan: $193.99 (Rate to be discussed individually with the client depending on their needs).

Travel for Outreach Appointments: $193.99 per hour

Provider & Care Team Meetings: Up to $193.99 per hour (inclusive of GST if applicable)

Parenting Courses and Workshops: TBA

We understand that families may face financial challenges. If you are concerned about your ability to pay, please reach out to our accounts manager. We are committed to supporting vulnerable and struggling families and will work with you to find a solution, including offering a reduced rate whenever possible.

Accounts Manager: accounts@playtherapytas.com.au

*Private Health Fund Rebates: Eligibility for rebates may vary based on your level of coverage and whether you possess a current GP Mental Health Care Plan or Enhanced Care Plan. Please consult your private health fund for further details.*