Client Intake Form

Client Information

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Appointment Preferences

If you have a preferred day or time for an appointment please indicate below and we’ll do our best to accommodate you.

1. Payment Consent: By accessing our service you give consent to assessment and treatment with MLSP Speech Pathology and accept responsibility for payment of fees for services rendered by the practitioner. Payment for service is required at the end of each session for privately paying clients and self-managed NDIS clients. Invoices may be issued after treatment as necessary.
2. Cancellation Policy:
   

   a) If you are unable to attend a session, you must provide MLSP with 2 business days’ notice. If you fail to notify MLSP 2 business days before your scheduled appointment, MLSP may charge for the cancellation of the session.

   b) NDIS participants will be charged for cancellations per the current NDIS pricing arrangements.

3. Service Agreements: NDIS clients will be required to sign a service agreement with MLSP which details your responsibilities and MLSPs responsibilities and outlines proposed plan for our involvement and budget.
4. Confidentiality and Clinical Information Release: You authorize MLSP to communicate with the interdisciplinary professionals involved in your care, and to release any relevant clinical information to those professionals as appropriate.
5. Use of AI Technology for Speech Pathology Documentation: At MLSP Speech Pathology, we use Heidi AI, a secure artificial intelligence tool, to support our clinicians with clinical note-taking and report writing . This helps ensure timely, accurate documentation and allows more time to be focused on your care.
   Heidi AI is designed specifically for healthcare settings and complies with relevant privacy laws, including the Australian Privacy Principles and the Health Records and Information Privacy Act 2002 (NSW). Only the necessary information is processed, and all data is managed securely and confidentially.
   If you would prefer not to have your session notes or reports generated with the assistance of this tool, you can choose to opt out at any time. Simply let your speech pathologist or our admin team know, and we will make a note of your preference.
6. To review our full Terms and Conditions click here.