Participant Pre-Screening and Suitability Assessment Form:
Purpose and Instructions

The Participant Pre-Screening and Suitability Assessment Form serves as a vital legal instrument for gathering the necessary information to determine whether XYSTON Pty Ltd’s services are appropriately aligned with the participant’s needs and goals under the National Disability Insurance Scheme (NDIS) framework. This form ensures regulatory compliance, mitigates potential risks, and enables the provision of high-quality, personalised support.

The comprehensive completion of this form is mandatory to assess service suitability and identify any factors that could impact the safety or effectiveness of service delivery. The information provided will be treated with the strictest confidentiality and in compliance with Australian privacy laws and the Privacy Act 1988 (Cth).

Purpose of the Pre-Screening Form

The purpose of this form is to:

  1. Evaluate Service Suitability: Assess whether the services offered by XYSTON meet the participant’s specific needs and align with their NDIS goals.
  2. Identify Potential Risks: Review behavioural concerns, medical conditions, and restrictive practices to ensure safe and effective service delivery.
  3. Facilitate Personalised Support Planning: Tailor a person-centred plan that reflects the participant’s individual preferences, cultural values, and care requirements.
  4. Ensure Compliance with Legal Obligations: Collect the necessary consents and authorisations to meet the requirements of NDIS regulations.

 

Instructions for Completion and Submission

The participant or their authorised representative is required to accurately and fully complete all sections of this form. This ensures we have the information necessary to deliver services efficiently and effectively.

Please note:

  1. Accuracy is Essential: Incomplete or inaccurate information may result in delays or the inability to provide services.
  2. Legal Documentation: Where applicable, please provide copies of legal documents such as guardianship orders or restrictive practice authorisations.
  3. Consent Requirements: All necessary consents, including permission for information sharing and service assessments, must be completed to avoid compliance issues.

If assistance is required during the completion process, our team is available to support you. You may contact our administration for guidance at any time.

    1. Participant Information






    2. Overview of Support Needs





    3. Behavioural Concerns



    4. Risk Factors




    5. Legal and Compliance Information





    6. Communication and Cultural Considerations



    7. Current Service Providers



    8. Emergency Contacts



    9. Consent and Acknowledgment



    10. Additional Information


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    Post-Submission Process

    Upon receipt of the completed form:

    1. Review and Verification: Our team will carefully assess the information provided to confirm service suitability and compliance.
    2. Follow-up Communication: If additional information or clarification is needed, we will contact the participant or their representative promptly.
    3. Next Steps: If services are approved, we will initiate the onboarding process, including the development of a service agreement and individual support plan tailored to the participant’s goals and needs.

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