Please complete this table for all of your delivery locations and the delivery locations of any consortium members or subcontractors. If you have more than four locations, you can copy and paste the table to a new page of this document. Intervention Domains Delivery location Profession Service Duration Total cost e.g. initial assessment X hours $X Language and communication e.g. Self-care, self-regulation and life skills e.g. standard session Smith Therapy, Physical / sensory / psychomotor development 123 Example Street, e.g. home / school visit Social and emotional development Suburb, Postcode Cognitive development and learning skills Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills Once you have completed the fee schedule, save a copy as Schedule Your Trading Name” and email it to for processing if it is an update, or attach it “Fee – to your application by clicking on the + symbol and selecting the saved fee schedule.
Please complete this table for all of your delivery locations and the delivery locations of any consortium members or subcontractors. If you have more than four locations, you can copy and paste the table to a new page of this document. Intervention Domains Delivery location Profession Service Duration Total cost Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills e.g. Smith Therapy, 123 Example Street, Suburb, Postcode e.g. initial assessment X hours $X e.g. standard session e.g. home / school visit Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills Language and communication Self-care, self-regulation and life skills Physical / sensory / psychomotor development Social and emotional development Cognitive development and learning skills Once you have completed the fee schedule, save a copy as “Fee Schedule – Your Trading Name” and email it to for processing if it is an update, or attach it to your application by clicking on the + symbol and selecting the saved fee schedule.
Schedule-Template-for-Service-Provider-Free-Download-MS-Word.docx