Before we start, please see the costs below and our current terms of engagement on the Health & Life website. Should you have any further queries, please call our office on (08) 8415 5400 or 1800 077 222
Completing this document
In order to execute the document;
Complete the below scheduling instructions so we can prepare the document for your review; and
In addition, please provide the following in relation to the new providers in order to keep the costs to a minimum for the practice:
1. Please provide the ABN registration record of each provider from ABN Lookup: http://www.abr.business.gov.au/
2. Please provide the AHPRA registration details,
3. Please provide the Medical Indemnity Insurance certificates for the new providers; and
4. The practitioner's bank account name and BSB and bank account number if you will be using our Doctors Pay Calculator outsourcing service where you can process cost-effectively process pays by a registered tax agent and accountant in minutes and not hours.
5. Written permission (e.g. in email) that the practitioner has agreed to provide this information to us. Send a copy of this template example of a Privacy and Consent form to the practitioner, copy, paste and email to pa@healthandlife.com.au the consent below.
" I [Full Name] of [Address] have reviewed the linked information. I hereby provide written permission to provide my personal information for the purposes of preparing a Service Agreement to Health and Life and the law firm appointed to act on behalf of the practice. Yours Kindly, [Full name] [Date] "
6. As we are not lawyers, consider seeking independent legal advice to ensure appropriate execution of the document. All parties should be provided with an opportunity to seek independent professional advice where necessary. We provide more information on how you can cost-effectively consult a legal adviser familiar with these agreements.
By submitting this form, you confirm that you wish to proceed under the terms of engagement above including but not limited to licencing and usage of any products we offer.