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IHC EOY Client Update Form

Client Details

First Name*
Please enter your first name.
Please enter your first name.
Last Name*
Please enter your last name.
Please enter your last name.
Email*
Please enter your email.
Please enter your email.
Mobile Phone*
Please enter your mobile phone number.
Please enter your mobile phone number.

Educator 1 Details

Educator First Name
Please enter Educator first name.
Please enter Educator first name.
Educator Last Name
Please enter Educator last name.
Please enter Educator last name.
Will you be requiring your Educator again next year?
  • - select a option -
  • Yes
  • No
Field is required!
Field is required!

What will be the last date your Educator will work this year?

Day
  • - enter the day -
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25
  • 26
  • 27
  • 28
  • 29
  • 30
  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!

What will be the first date your Educator will work next year?

Day
  • - enter the day -
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25
  • 26
  • 27
  • 28
  • 29
  • 30
  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!

Please fill in the hours and days for next year

Shift 1

Monday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Shift 2

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Tuesday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Wednesday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Thursday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Friday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Saturday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Sunday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Educator 2 Details

First Name
Field is required!
Field is required!
Last Name
Field is required!
Field is required!
Will you be requiring your Educator again next year?
  • - select a option -
  • Yes
  • No
Field is required!
Field is required!

What will be the last date your Educator will work this year?

Day
  • - enter the day -
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25
  • 26
  • 27
  • 28
  • 29
  • 30
  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!

What will be the first date your Educator will work next year?

Day
  • - enter the day -
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25
  • 26
  • 27
  • 28
  • 29
  • 30
  • 31
Field is required!
Field is required!
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Field is required!
Field is required!
Year
Field is required!
Field is required!

Please fill in the hours and days for next year

Shift 1

Monday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Shift 2

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Tuesday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Wednesday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Thursday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Friday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Saturday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Sunday

Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!
Start Time
Field is required!
Field is required!
Finish Time
Field is required!
Field is required!

Confirmation

Do you understand that when an Educator attends a shift on a public holiday, the family will be charged much higher out of pocket expenses? (Please contact us for a quote before allowing your Educator to work)*
Please confirm.
Please confirm.
Do you understand that Educators may claim KM reimbursement costs directly from the family using the link on our Website?* https://www.australiasleadinghomecareagency.com.au/km-reimbursement-request-form/
Please confirm.
Please confirm.
Do you understand that if the length of the shift is shortened or lengthened, it may result in a higher out of pocket expense being charged to the family? (Please contact us for a quote before making any changes)*
Please confirm.
Please confirm.
Do you understand that if either the Family or Educator are taking time off, the agency must be contacted IN ADVANCE so that we can offer the Educator alternate work or the Family an alternate Educator?*
Please confirm.
Please confirm.
Do you understand that it is an offence under Family Assistance Law when Families allow or instruct Educators to enter sessions of care where a child or Educator is not present?*
Please confirm.
Please confirm.
Do you understand that it is an offence under Family Assistance Law when Families approve rather than reject timesheets that do not accurately reflect the attendance of the children in care?*
Please confirm.
Please confirm.
Do you understand that if a Family member or Educator is unwell, you must report to the agency immediately for advice?*
Please confirm.
Please confirm.
Do you understand that Families must not ask Educators to participate in activities where there is a high risk of injury e.g. trampoline centers, rock climbing walls, ice skating etc.? (Educators are to encourage and assist children to undertake physical activities however must not participate themselves)*
Please confirm.
Please confirm.
Do you understand that if any incident occurs during a session of care involving injury, harm or trauma to or illness of a child, where medical attention was sought or ought to have been sought, or hospital attendance occurred, or where a child is missing or appears to have been taken, removed or locked in or out of a premises, it MUST be reported to the Agency immediately?*
Please confirm.
Please confirm.
Do you understand that PRIOR to shifting to a new address that a new Home Safety Assessment must be completed and that it is the Families responsibility to notify the Agency in advance?*
Please confirm.
Please confirm.
Do you understand that PRIOR to care being provided in a temporary alternate location, that the Agency must seek permission from the Department of Education and that it is the Families responsibility to notify the Agency in advance?*
Please confirm.
Please confirm.
Do you understand that Educators are entitled to take 2 paid interrupted on premises breaks for shift longer than 10 hours and 1 paid interrupted on premises breaks for shifts between 6 and 10 hours? (The children should either be asleep or be undertaking independent play whilst the educator puts their feet up, can do some internet banking, have a cuppa, read a book while keeping an eye and ear out for the security, health and wellbeing of the children)*
Please confirm.
Please confirm.
Do you understand that Educators are to be given access to internet, permitted to serve an additional portion of food and snacks for themselves, modeling appropriate table manners and good eating habits?*
Please confirm.
Please confirm.
Educators are also required to fill in a form, have you spoken directly to the Educator about the above?*
Please confirm.
Please confirm.
The information in this form will be used to update your Families future bookings, would you like one of our team members to contact you to discuss further?*
Please confirm.
Please confirm.
I confirm that all information completed within my Update form is true and accurate. I also agree to allow The Agency to share my information with Educators and other authorised personnel*
Please confirm.
Please confirm.