WA NDIS is the West Australian version of NDIS. We like to be a little different in the West and the WA state government has put its own… on the national NDIS model. Talk to the staff at TLCU will help you regarding any problems.

It shouldn’t but there are medical reasons why it may like nerve damage……

It can take a while to “break in”a new device a bit like buy a new pair of shoes. If you walk too far in new shoes you can get blisters.

At TLCU we don’t like our clients wearing painful devices so if there is any issue call us!

There are many different ways that you device will be attached to you.

These days the most common is a silicone type liner and pin lock system. TLCU will discuss the options with you. We want you to have the most comfortable and practical solution to suit your life style

It can take a while to adjust to a new device and there will be some fine tuning required.

Its important to talk openly with you clinician about any problems you may have. Its their job to work with you to help achieve the best out come.

Yes – but you may need a special sports device.

Please discuss your sports needs with TLCU clinicians who will work with you and design your special device.

TLCU Privacy Policy

The Law provides you certain privacy rights in relation to information that you give to this clinical practice. This form explains your rights in relation to the personal information we collect and how we may use it and disclose it, when necessary, to others involved in your healthcare.

The information we may ask you to give us is personal, but not having it will restrict our capacity to provide you with the standard of healthcare you expect. We will respect the information you give us and will store it securely. Hard copy records are stored in client files in a locked cabinet onsite. Electronic records are stored on an offsite server which is backed up daily. Hard copy records are incinerated after 7 years.

The main reason we collect information from you is so we can assess, diagnose, and treat you properly and be pro-active in your health care. We may use the information you provide in the following ways:

• Administration of this clinical practice

• Billing of our services - NDIS; WALSA; Medicare; Health Insurers; Lawyers; Trustees and carers requirements

• Disclosure to others involved in your health care, including NDIS planners & advisors; doctors; specialists; and carers outside this practice who may become involved in your treatment. When necessary, we will discuss this with you.

• Disclosure to staff and professionals within this clinic for the purpose of your care. Please let us know if you do not want your records accessed for any reason and we will note your file accordingly.

• Disclosure for teaching, research and quality assurance activities improve individual and community health care and the advancement of this practice's techniques or clinical management. You will be informed when such activities are being conducted and given the opportunity to "opt out" of any involvement.

Terms of Service Agreement

TLCU’s Terms of Service outlines how we provide our services. It includes our rights and responsibilities as a Service Provider, and your rights and responsibilities as a client.

Our Terms of Service are subject to change. We will provide notice before any changes take effect. If you have any questions regarding our Terms of Service, please call 08 9277 2988 or email contact@tlcu.com.au.

RIGHTS & RESPONSIBILITIES

What you can expect from TLCU and what we ask of you

We will:

· Involve you with decision about your life

· Make sure you have all the information you need, and it is explained it you

· Develop a prosthetics/physiotherapy plan with you and your carers/guardians

· Keep records of the services/products we provide to you

· Ask for your feedback & suggestions

· Promote safe work practices and environments

· Make sure all staff have relevant qualifications

· Respect your privacy and cultural practices

· Make sure that your information is protected

· Follow NDIS Practice Standards, so our services & products are of a high quality

You can:

· Receive and stop services when you need them

· Expect our staff to be respectful and considerate

· Request an interpreter or translator, if you need one

· Access your personal information, plans and notes when you like

· Provide feedback at any time

We ask you to:

· Work collaboratively with our staff

· Be considerate of other clients when visiting our clinic and during classes

· Respect the property, resources and staff at TLCU

· Provide information about any health conditions you may have

· Read, understand, and sign our Service Agreement, so that we can provide services

· Let us know if you need to change or cancel your appointments

CHARGES/INVOICING

What we charge and you can expect to be invoiced for. Please note our pricing is subject to change, based on the NDIS Price Guide (which is reviewed annually).

We don’t charge for the following activities:

· Booking appointments with you

· Setting up NDIS services, completing Service Agreements & creating Service Bookings

· Completing invoices and payments

· Clinicians or students who attend appointments as a part of a learning program

We charge for the following activities:

· All appointments with your Clinician (Prosthetist or Physiotherapist). If there is more than one Clinician at an appointment, you will be charged for each Clinician. We will discuss who attends appointments with you prior to your appointment

· If you are late to an appointment, you will be charged from the commencement of your booked time, not the time you arrive at the clinic (e.g., if you have a booked appointment for 9:00am and arrive at 9:30am, you will be charged from 9:00am)

· Liaising with the people in your life to make sure you are maximising the most out of your plans. This includes but is not limited to anyone listed under ‘Professionals/Agencies’ on the Service Agreements, carers, guardians etc.

· Talking with you in person, by phone, text message, social media or email

· Assisting you with Assistive Technology requests. We will charge 8 hours for these reports if it is a new device, or 2 hours if it an exact replacement of what you have already been provided

· Completing assessments and reports

· Writing NDIS Plan Review Reports. We will charge 2 hours for these reports

CANCELLATIONS

If you need to change or cancel your appointments, we ask that you provide 24 hours’ notice and let us know within our regular business hours (Monday to Friday, 8:30am to 4:30pm)

To cancel or change your appointment please contact our Administration Team on 08 9277 2988 or contact@tlcu.com.au during business hours. Please do not contact your Clinician directly, as they may not receive your message in time.

If you miss an appointment or cancel within 24 hours, we will charge you the full cost of your appointment.

If you cancel often, we will discuss your services and goals with you to see what we can do to help you attend your appointments. If we can’t find a solution, then we may decide to stop providing services until you are able to attend your appointments.

If your Clinician needs to cancel an appointment, we will do our best to reschedule and provide appropriate notice and/or book you in with another Clinician at your scheduled appointment time.

NDIS SERVICE BOOKINGS

We need an active Service Booking in the NDIS Participant Portal to start delivering services. A Service Booking allocates funding from your NDIS Plan for your services we will provide over the agreed timeframe.

If you have asked the NDIS to manage all or part of your funding, we will claim payment after we have provided services. This is referred to as an NDIS or Agency Managed Plan.

If you have an Agency Managed Plan, we can make a Service Booking on your behalf. If you want us to do this for you, please provide consent in your Service Agreement.

You can see what we have charged for in the NDIS Participant Portal. You can also request a statement of services from us at any time.

INVOICE PAYMENTS

If you are a self-managed or private client, payment is required to be paid upfront and prior to any consumables/components being ordered or work started on your behalf.

If you are managing part of your NDIS funding or if you are using a Plan Manager, we will send invoices after we have provided services. Invoices may be sent for consumables once ordered and received by TLCU to cover costs from the supplier.

Invoices are provided within the week of you receiving your service &/or products. Payment is required within 14 days of the invoice date.

Invoices can be paid by direct deposit or credit card. Please use the invoice number as the reference when you are making a payment. A receipt will only be provided on request.

You have seven (7) days from the date of invoice to raise any issues with our Administration/Accounts Team.

· If payment isn’t received within 14 days, you’ll receive a phone call from our Admin/Accounts Team making sure you’ve received the invoice and to provide any assistance (if needed)

· If payment isn’t received with 21 days, we will follow up with you again. If payment is not received within 28 days, we will unfortunately suspend your services, until payment resolved

· If payment isn’t received within 42 days, we will refer your case to a debt collection agency, whereby you will be responsible for all the charges associated with the collection of your debt.

For all AT (Assistive Technology) approved quotes from NDIS, TLCU will request that full payment is made prior to the commencement of your device. This is for Self-Managed clients or private clients only.

It is reasonable and has been approved by NDIS, WALSA and Plan Managers for TLCU to seek part-payment of the quoted job in relation to the cost of the components/parts. This is only invoiced once the components have been ordered and received by TLCU. This is the usual process for high value components. This may be prior to the completion of your job, however the labour costs will always be invoiced at the completion/finalisation of your job.

FEEDBACK & COMPLAINTS

We want to know when the services provided are going well and when there are issues.

You can provide us feedback by:

· Contacting your Clinician or Administration Team directly in writing, or in person

· Contacting our Management Team on 9277 2988 or management@tlcu.com.au

Once we receive your feedback, we will address your comments and if appropriate take action as soon as possible. We will contact you within a week to discuss your feedback and let you know of any actions taken.

If you would prefer to speak with someone outside of TLCU, you can contact:

· NDIS Quality and Safeguards Commission

Phone them on 1800 035 544 or visit ndiscommission.gov.au OR

· People with Disabilities WA

Phone them on 1800 193 331, email info@pwdwa.org or visit their office

Liability Consent

I understand and agree that I am responsible for any amount not covered by my insurance company, workers compensation claim, NDIS or motor-vehicle accident claim.

If a third party insurer rejects or removes liability , I understand that I will be liable for payment of any unpaid accounts.

Amputee Gym Agreement & Disclaimer

You should always consult your physician or other healthcare provider before changing your diet, starting an exercise program. I have completed the Adult Pre-Exercise Screening Tool Paperwork provided to me by TLCU.

I hereby assume full responsibility for any and all injuries; losses; damages that I incur while participating in the TLCU Gym. I hereby waive all claims against the TLCU Gym and instructors for any and all injuries, claims or damages that I might incur.

I acknowledge that the TLCU Gym is intended to provide supervised low-moderate intensity physical exercise, mobility and transfer practice, and an element of informal social support; and that provision of this service by TLCU is made in good faith to the amputee community.

I agree that my attendance in the group exercise sessions at TLCU is voluntary, and my participation can be stopped by myself or TLCU staff without notice.

I agree that, out of courtesy, I will endeavor to provide 24hrs notice (where reasonable) to TLCU should I need to cancel or change my gym session.

I agree to show respect for TLCU and other participants during the gym sessions. This includes but is not limited to taking responsibility for my own safety and that of others, by following instructions of the supervising TLCU staff at all times. I understand that if I fail to do so, I may be asked to leave and that my access to the gym sessions may be restricted or ceased without notice.

I acknowledge and understand that matters relating to my prosthesis will not be addressed during these exercise sessions, and that I am required to make a separate appointment with my own prosthetist outside of this time, if there are prosthetic issues.

Dry Needling Informed Consent

Prior to consenting to the use of dry needling as a form of manual treatment technique please review the following information.

Dry needling uses single-use, sterile needs to aid in muscle release and reduce trigger point sensitivity to an individual's musculoskeletal pain. Complications are very uncommon (general risks 8-10% - bruising/bleeding, fatigue/drowsiness, post needle site pain; severe risks 0.0005% - pneumothorax, hemopneumothorax, infection). It is for these reasons each patient must be notified prior to giving informed consent to the treatment method.

I confirm that I have read and understood this agreement prior to signing it, and I am aware that by signing this agreement I am waiving certain legal rights which I or my heirs, next of kin, executors, administrators assigned as representatives may have against TLCU.

New Client Initial Consent Summary

• I have read and understood TLCU's Privacy Policy, Terms of Service and Amputee Gym Agreement that can be viewed on our website (www.tlcu.com.au) or in hardcopy at Reception.

• I understand I am not obliged to provide any information requested of me. I also understand that failure to provide TLCU with all the information may restrict TLCU's ability to provide the quality of health care and treatment I want.

• I am aware that I have the right to access the information collected about me. Except in some circumstances where access might legitimately be withheld, I understand I will be given an explanation in these circumstances.

• I understand that if my information is to be used for any purpose other than that set above, my further consent will be obtained.

• I consent to the handling of my information by this clinic for the purposes set above, subject to any limitations on access or disclosure about which I notify this clinic now or any future time.

• I will update TLCU with all up-to-date funding information.

• I acknowledge that I have read this form before signing it and that a member of staff of TLCU has, at my request, clarified any aspects of it that I did not at first understand.