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First Name

Last Name

Therapist Discipline

Occupational Therapist

Physiotherapist

Speech Therapist

Behaviour Support

Dietitian

Podiatrist

Psychologist

Social Worker

Counsellor

Support Coordinator

Remedial Massage Therapist

Osteopath

Exercise Physiologist

Art Therapist

Music Therapist

State

ACT
NSW
NT
QLD
SA
TAS
VIC
WA
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1. How long have you been a clinician?

0-2 years

3-5 years

5-10 years

10+ years

2. How much experience do you have in NDIS?

0 - 2 years

3 - 5 years

5 - 10 years

10+ years

3. How many days a week do you currently work?

2

3

4

5

4. How many billable hours do you currently need to meet? (if applicable)

11 - 15

16 - 20

21 - 25

26 - 30

30+

5. If you could only pick one, which is the most important motivating factor to start your Independent Practice?

More Flexibility

Support My Family

Increased Pay

Decrease Working Hours

More Control

6. Do you already have an ABN?

Yes

No

7. How long have you been thinking about Independent Practice?

First time

0 - 6 months

6 - 12 months

1 - 3 years

3 + years

8. Ideally, how soon would you like to commence supported independent practice?

4 - 6 weeks

8 - 12 weeks

12+ weeks

9. What is the number 1 thing that has held you back?

Email *

Phone *

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