NDIS Consultation / Trial Form

Thank you for contacting Kidsafe QLD.

In this form we refer to 'client' as the person requiring consultation or requiring mobility support. So that we can reduce wait times, we appreciate you taking the time to answer the questions and giving contact details of all the parties concerned. 

If you have difficulties completing the form, please contact us on 07 3854 1829.

This allows us to give you continuity of care and refer back to previous consultation notes.

Parent/Carer contact details

Allied Health contact details


Funding details


Client information

So that we can select the right products to suit the client's needs, we need to know more about their physical size.


We understand that it can be complex to specify a medical condition and that there can be multiple factors. The above information is just to give us a snapshot and we will gather all information during the consultation



Additional information

The make and model of the vehicle will inform which products we recommend. It is also necessary that the noted vehicle is present at the initial consulation appointment.

If you are requesting and in-person consultation [only available in SE Qld], please indicate possible appointment times below. If you are requesting a trial [online consultation], leave the following four questions blank.


Service agreement & fees

In-person Consultation Fees | Seating Solutions

Over 9 Years Old

1. In-person Consultation Fee is $156.16 per hour or part thereof within the Brisbane CBD.  

2. For South East QLD locations outside of the Brisbane CBD, Provider Travel Labour Costs will be charged at $78.08 per hour or part thereof, within your MMM classification limit.   

3. Provider Travel Non Labour Costs will be charged at 0.99c per Kilometre. 

4. An invoice for consultations will be issued at completion of the appointment and payable within 14 days.  

5. Consultation fee/s are payable by client even if funding is not approved/ available and regardless of the quotation being accepted.  

6. After consultation, a quote for delivery, installation, supply of agreed products e.g. child car restraint, modifications, harnesses or accessories will accompany the consultation invoice.  

7. Products are not supplied, delivered or installed until payment has been received for product and any consultations.  

8. A follow-up online consultation is available to ensure the product is working and being fitted properly. Consultations are conducted via Zoom and are $78.08 for 30min.  

Under 9 Years Old (Early Childhood)

1. In-person Consultation Fee is $193.99 per hour or part thereof within the Brisbane CBD.  

2. For South East QLD locations outside of the Brisbane CBD, Provider Travel Labour Costs will be charged at $97.00 per hour or part thereof, within your MMM classification limit.   

3. Provider Travel Non Labour Costs will be charged at 0.99c per Kilometre. 

4. An invoice for consultations will be issued at completion of the appointment and payable within 14 days.  

5. Consultation fee/s are payable by client even if funding is not approved/ available and regardless of the quotation being accepted.  

6. After consultation, a quote for delivery, installation, supply of agreed products e.g. child car restraint, modifications, harnesses or accessories will accompany the consultation invoice.  

7. Products are not supplied, delivered or installed until payment has been received for product and any consultations.  

8. A follow-up online consultation is available to ensure the product is working and being fitted properly. Consultations are conducted via Zoom and are $96.99 for 30min.  


Online/Zoom Consultation Fees

Over 9 Years Old

1. Kidsafe QLD services clients nationwide. Any clients living outside of South East Queensland area map can access our online services. 

2. To ensure the product you are trialing or purchasing is suitable for your client / child, we offer a 30-minute consultation via Zoom. Online/Zoom Consultations are charged at $78.08 per 30min or part thereof.

3. An invoice for consultations will be issued at completion of the appointment and payable within 14 days 

4. Consultation fee/s are payable by client even if funding is not approved/ available and regardless of the quotation being accepted. 
 

5. Following consultation, any products requested for trial will be invoiced. 
 
 

6. Products are not supplied until payment has been received for product and any consultations. 

7. A follow-up online consultation at the end of the trial period is recommended to ensure the product is working and being fitted properly. Online/Zoom Consultations are charged at $78.08 per 30min or part thereof.


Under 9 Years Old (Early Childhood)

1. Kidsafe QLD services clients nationwide. Any clients living outside of South East Queensland area map can access our online services. 

2. To ensure the product you are trialing or purchasing is suitable for your client / child, we offer a 30-minute consultation via Zoom. Online/Zoom Consultations are charged at $96.99 per 30min or part thereof.

3. An invoice for consultations will be issued at completion of the appointment and payable within 14 days 

4. Consultation fee/s are payable by client even if funding is not approved/ available and regardless of the quotation being accepted. 
 

5. Following consultation, any products requested for trial will be invoiced. 
 
 

6. Products are not supplied until payment has been received for product and any consultations. 

7. A follow-up online consultation at the end of the trial period is recommended to ensure the product is working and being fitted properly. Online/Zoom Consultations are charged at $96.99 per 30min or part thereof.


Trial of behavioural harnesses, postural harnesses and accessories.

1. After a consultation or on request, products are loaned for trial at a rate of $150 per week for one harness. Additional harnesses in the same trial are charged at $110 each per week. Postage charges inclusive of return costs apply (Express services)

2. Some items (such as Buckle Covers and Best Vest) are available at a lower trial rate.

3. Trials are for the intended purposes of trialling equipment to determine suitability - We do not offer hire services for our products.

4. If trialed products are successful, a quote/ invoice is raised for purchase. 

5. Kidsafe QLD Trial Rebate Program

A trial rebate is available through Kidsafe QLD, subject to the following eligibility criteria:

  • The purchased product must have been trialed through Kidsafe QLD's paid trial service.

  • The purchase of the product must proceed directly following the completion of the trial. Reasonable flexibility may be provided where additional time is required to obtain funding approval.

  • A rebate of $100 is available only where the successfully trialed product has a purchase price exceeding $1,700.

  • Only one harness purchase per participant is eligible for the rebate.

  • All Kidsafe QLD invoices issued in the participant's name must be paid in full, with no outstanding amounts owing at the time of purchase.

Kidsafe QLD reserves the right to determine eligibility for the trial rebate and to amend or withdraw the rebate program at any time.

6. Trial products remain the property of Kidsafe QLD and cannot be retained for purchase.  

7. Near the end of the trial period, a follow-up 30-minute online consultation is recommended if any of the products need to be changed. A revised product quote may be necessary. 

Terms and conditions

These Terms and Conditions apply to quotes / invoices supplied for consultation services by Kidsafe QLD at an agreed location.  

We use the following term: 

“Kidsafe QLD” means Kidsafe Queensland Inc. 

“Client”, “you”, or “your” means your service / organisation or individual (parent / carer) 

Quotes 

Quotes are estimates based upon the products / modifications / accessories trialed by the client and or other party. Quotes are subject to change in the event of product price increases.  

Quotes are only valid for 60 days from the date of issue.  

Venue/location and workplace safety 

All parties are required to ensure that the inspection site has been assessed as suitable for Kidsafe QLD staff to provide service (refer to Risk Assessment Policy on Kidsafe QLD website). 

Code of conduct 

Requires workers and providers who deliver NDIS supports to:  

  • Respect for individual rights to freedom of expression, self-determination, and decision-making in accordance with relevant laws and conventions  

  • Respect the privacy of people with disability

  • Provide support and services in a safe and competent manner with care and skill 

  • Act with integrity, honesty, and transparency 

  • Promptly take steps to raise and act on concerns about matters that might have an impact on the quality and safety of supports provided to people with disability 

  • Take all reasonable steps to prevent and respond to all forms of violence, exploitation, neglect, and abuse of people with disability 

  • Take all reasonable steps to prevent and respond to sexual misconduct

Product availability 

Purchases: Kidsafe QLD does not stock large quantities of products. Delivery times for products that are not currently in stock are dependent on manufacturer and supplier lead times and may therefore vary.

Trials: If a trial invoice has been paid and the requested trial product(s) are temporarily unavailable due to stock levels or existing trials, you will be placed on a waitlist. We will contact you via email to advise of this, and outline the expected wait time. This wait time is an estimate based on awaiting trial returns and is not guarenteed. Items will be provided as soon as they become available.

Completion of service agreement 

The service agreement will cease once all approved products have been supplied and installed by Kidsafe QLD, or Kidsafe QLD has been notified by parties involved they no longer wish to proceed. At this stage any applicable consultation fee/s must be paid in full. 

Re-trial / 2nd consultations: 

Fees for subsequent consultations are applicable as per our service agreement. 

Cancellation policy 

At our discretion we may invoice for any work or expenses if any consultation is cancelled within 12 hours of the confirmed date and time of the booked service or not attended. 

Product/ service satisfaction 

If you or the client have any concerns regarding a service or product provided by Kidsafe QLD, please contact Kidsafe QLD directly on 3854 1829 or email disabilities@kidsafeqld.com.au. 

Product warranties will apply and it is the client’s responsibility to ensure warranty terms and conditions have been met. Kidsafe Qld is not responsible for any product/s that are damaged due to misuse and the warranty is voided. 

Alternatively, contact National Disability Insurance Scheme Quality and Safeguards Commission www.ndiscommission.gov.au/about/complaints 

Confidentiality 

It is agreed that employees of Kidsafe QLD shall not at any time either during the consultation or thereafter, divulge any confidential information about the client to anyone whatsoever without the client’s consent in writing. 

Trial products 

Policies and procedures are enforced to ensure the security of our equipment. By agreeing to borrow Kidsafe QLD equipment and products, you agree to follow the procedures, terms and conditions. 

1) The customer will accept full responsibility of the trial equipment for any damage, loss or disfigurement sustained while in your possession. 

2) The customer accepts that the costs of any required repairs or replacement for the equipment will be borne solely by the customer.  

3) The customer is deemed to be in possession of the product from the point in which they receive the equipment. The equipment will be deemed to have been returned when the equipment has been safely returned to the Kidsafe QLD premises. 

4) The customer is responsible for the return of the equipment by the agreed due date. A late fee will be charged on a daily basis for any late returns. Merely shipping out the equipment before the due date is not sufficient, the equipment is deemed to be returned once it has arrived at the Kidsafe QLD premises. 

5) The trial equipment must be returned in full. Any partial return or return missing components will not be accepted. The equipment will not be deemed to have been returned till all the components have also been returned. If the customer is unable to locate any components, then you will be charged for the appropriate replacement costs. 

6) All loans and trials must be approved by one of our sales staff. 

7) Extensions for the duration of the equipment trial may only be extended if authorised by our sales staff. 

8) The trial equipment cannot be used in any manner that goes against the agreed purpose. If the customer wishes to use the trial equipment for a different purpose, then authorisation from one of our sales staff is required. Any use outside the agreed purpose may result in the customer having to return the loaned equipment earlier than agreed on and incurring a fee. 

9) Any misuse, damage or loss of the equipment may result in Kidsafe QLD denying any further loans or trials to the applicable customer. 

10) The customer accepts that Kidsafe QLD can demand the equipment to be returned early if there is suspicion of any misuse or damage to the borrowed equipment. 

IN THE SIGNATURE PANEL BELOW YOU CAN SELECT:
'DRAW SIGNATURE' to use your finger to write your signature on a mobile device (phone or tablet) 
'TYPE SIGNATURE' - to use your keyboard to write your signature (phone, tablet or desktop)

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By signing you agree that you have read and understood Kidsafe QLD's terms and conditions and service agreement.


We will be in touch with you as soon as possible