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Restrictive Practices Consent and Authorisation Form sample page preview

Restrictive Practices Consent and Authorisation Form

$24.99
Instant download. One-time purchase. Fully editable Word (DOCX).

A restrictive practices consent and authorisation form for each participant subject to regulated restrictive practices. It records consent from the participant or their legal decision-maker and tracks external state or territory authorisation.

What is inside:

  • Section A: participant and plan details, the implementing provider and the specialist practitioner
  • Section B: details for each proposed practice, including prohibited physical restraint techniques
  • Section C: decision-making capacity assessment and outcome
  • Section D: participant consent, or legal decision-maker consent with proof of authority
  • Section E: state or territory authorisation details, expiry and a 90-day renewal reminder
  • Section F: reduction and elimination acknowledgement
  • Section G: specialist practitioner certification

Good to know: completing this form does not itself authorise any restrictive practice. Keep it on the participant's file for the duration of service plus 7 years.

  • Reviewed against the current NDIS Rules, Practice Standards and Commission guidance
  • Editable DOCX with a placeholder legend, so you enter your details once
  • Instant download

These templates are general information, not legal advice. No template can guarantee registration or audit outcomes.

Buying more than one template? This one is also in

On its own this template is $24.99. Each pack below includes it, plus the rest of the set.

Behaviour Support Add-On Module16 documents, about $9.31 each $149View pack Complete NDIS Provider Document Library358 documents, about $3.06 each $1,099View pack
Digital product. Because these are instant downloads, we do not offer refunds for change of mind once your files have been accessed. This does not affect your rights under the Australian Consumer Law. Bought the wrong pack? Contact us within 30 days and we will credit what you paid towards the right one. If you have a technical issue accessing your files, contact us and we will sort it out. See our refund policy.
Your responsibility. These are editable templates provided as a starting point, not legal, compliance or professional advice. You are responsible for reviewing each template, adapting it to your service, and making sure the information is current, accurate and appropriate for your circumstances and your state or territory before you rely on it. Moreton Regional Support Services is not liable for any loss, penalty or outcome arising from your use of these templates, and no template can guarantee NDIS registration, audit or compliance outcomes.

Add-on modules and other packs

Add only what you deliver. Every pack drops into the same document system, so you can extend your library as your scope grows.

Independent Support Worker Verification Pack$249View packNDIS Provider Core Library$599View packSIL Supplementary Module Add-On$149View packComplete NDIS Provider Document Library$1,099View packHigh Intensity Supports Add-On Module$199View packNDIS Employer Essentials Pack$149View packBusiness Extras Pack$129View packBehaviour Support Add-On Module$149View pack