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Berkman Academy Forms

First time visitor (Private): Complete form 1: Risk Warning and Waiver of Liability. 

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First time visitor (NDIS participant): Complete forms 1 and 2.

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Want to visit again? Complete form 3: Contact Details and Medical History

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On NDIS and after a longer term plan?

Complete form 4: NDIS Service Agreement​

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If you have any issues completing the forms, please email: hello@berkmanacademy.com.au.


Hard copies are available on request.

​All forms are stored securely and confidentially.

A PDF copy can also be emailed to you once submitted.

1. Risk Warning and Waiver of Liability

Must be completed by every person before their first visit to Berkman Academy.

Complete Form
 

2. NDIS Billing Details

For NDIS participants invoicing purpose.

Complete Form

3. Contact Details and Medical History

For clients continuing after their first session. Helps us understand your needs and keep you safe.

Complete Form

4. NDIS Service Agreement

For NDIS clients booking ongoing sessions using their NDIS funding.

Complete Form

We acknowledge the Traditional Custodians of the land on which we work, the Wurundjeri people of the Kulin Nation.

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We recognize their deep and enduring connection to this land, water, and community, and we pay our respects to their Elders past and present.

 

We honor the strength, wisdom, and culture of First Nations people and acknowledge that sovereignty was never ceded.

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