Complimentary NDIS Health Check Discovery Form for NDIS Providers (Vertex360 Platinum Plan)

Client Information

Business Name: ABN (Australian Business Number): Contact Person: Position/Role in Organisation: Phone Number: Email Address: NDIS Provider Number: Number of Participants Supported: Number of Employees:

Standard Internal Desktop Audit Details

Scope of Audit: Participant Files and Records ComplianceStaff Training and Qualifications CompliancePolicies and Procedures Alignment with NDIS StandardsIncident Reporting and Risk Management DocumentationOther (Please specify): If "Other", please specify: Do You Have Any Existing Internal Audit Reports? YesNo If Yes, Please Attach the Most Recent Audit Report: Are There Specific Areas of Concern You Would Like Addressed? (Optional):

Additional Services (Optional)

Do You Require Additional Audits or Reviews Beyond the Standard Desktop Audit? YesNo If Yes, Please Specify the Additional Services Required: Acknowledgement of Additional Costs: I understand that any additional services beyond the standard desktop audit will incur extra charges, and a quote will be provided based on the complexity of the request.

Terms and Acknowledgements

Terms of Complimentary Service:

The complimentary service includes one internal desktop audit per year, focused on reviewing key compliance areas with NDIS standards.
This offering is provided by Vertex Consultants and is subject to its sole discretion.
Additional services such as further audits, implementation of recommendations, or on-site reviews will incur charges based on complexity.

Acknowledgement: I understand the terms of the complimentary service and the associated costs for additional services. Signature (Electronic signature or name and date):

Submission

Please review your information before submitting.

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