Worker Screening Declaration Form
$24.99
Instant download. One-time purchase. Fully editable Word (DOCX).
A worker screening declaration form that every worker completes at engagement and updates whenever their screening status or relevant circumstances change. One form per worker is filed in their personnel record.
What is inside:
- Worker details: name, date of birth, contact details, role, employment type and start date
- NDIS Worker Screening Check details, including clearance number, dates, issuing authority and any past suspension or exclusion
- National Police Check details and disclosure of pending charges, with guidance on spent convictions
- Working with Children Check details where the role involves children
- Suitability declaration on relevant offences, past disciplinary findings and dismissals
- Ongoing obligation to notify you of changes to clearances, charges or convictions
- Worker declaration and consent to verify clearances
- Office use section for database verification and clearance to commence
- 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.
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