Support
03 8521 7180
Email Help
aca@focusinsurance.com.au
Support
03 8521 7180
Email Help
aca@focusinsurance.com.au
Combined Professional Indemnity and Public/Products Liability Insurance for members of the Australian Counselling Association
Guidance Notes
a. It is vitality important that you complete this form accurately to comply with your important
Duty of Disclosure
obligations
b. This policy is only available to ACA members domiciled in Australia
c. This policy will only cover counselling and psychotherapy practices/modalities that form part of your counselling qualifications recognised by Australian Counselling Association
d. This policy can be extended to cover other approved Allied Health Modalities / Services that can be selected below. Cover will only apply if you hold industry recognised qualifications.
e. This policy is for sole practitioner ACA members only. If you operate a Counselling or Allied Health clinic that employ other allied health practitioners, please contact our office to discuss.
Thank you for taking the time to visit us. It will take you approximately 90 seconds to obtain a quote and another 3 minutes to arrange your cover and receive your policy documentation.
Please fill out your details below to obtain your insurance quote
Are you a member of the Australian Counselling Assocation?
Yes
No
Are you in the process of applying for membership?
Yes
No
Australian Counselling Association Membership Number
Your Professional Business Activities
Please select the services or modalities you would like to cover (tick those which apply to you)
Counselling Activites
Counselling
Psychotherapy (Including Art Therapy, Play Therapy, Music Therapy)
Clinical or Professional Supervision in counselling / psychotherapy
Teaching / Training in relation to counselling / psychotherapy
Walk and Talk Therapy (Low Hazard Terrain only i.e. foot path, flat landscape, etc)
Equine Assisted Therapy
Dog Assisted Therapy
Sex Therapy Counselling
Nutritional Counselling
Other Counselling services
Please provide details
Life Coaching (Therapy based only)
Havening
Eye Movement Desensitization and Reprocessing (EMDR)
Neuro Linguistic Programming
Cognitive Behavioural therapy
Do you hold industry recognised qualifications for the modalities / activities you have selected above?
Yes
No
Other Services / Activities - Please tick if cover is required
Hypnotherapy
Mental Health First Aid Practitioner
Reiki
Meditation Therapy
Yoga classes (up to 20 people only per session)
Naturopathy
Massage Therapist
Social Worker
Provisional Psychologist
Registered Psychologist
Mental Health Nurse
Family Dispute Resolution Counsellor
Unfortunatley we are not able to offer cover for Family Dispute Resolution Practitioner under this policy.
Please contact our office if you would like a separate policy for this work
Life Coaching (Non therapy based)
NDIS (Please do not select this box if you only provide counselling/psychotherapy services to NDIS participants)
Other
Please provide details
Please select the NDIS service's that apply to you
NDIS Behaviour Support Coach
NDIS Recovery Coach
NDIS Mental Health Support Worker
NDIS Complex Case management Worker
NDIS Home visiting Support Worker
NDIS Specialist Support Coordinator
NDIS Plan Manager
NDIS Support Coordinator
NDIS Support Worker
Other
Please provide details
NDIS Support Work additional questions
Please tick the services you provide below
Personal Care
Assistance with eating and drinking
Assistance with prescribed exercises
Assistance with self-medication
Dressing
Grooming
Oral hygiene
Showering
Toileting
Other
Please detail other services provided
Domestic Assistance
Change sheets and towels
Clean kitchen
Clean toilet and bathroom
Put council bins out
Clean windows, screens and fans
Clean windows, screens and fans
Dust
Ironing
Mop floors
Vacuum
Remove rubbish
Wash, dry, fold
Other
Please detail other services provided
"Unfortunatley we are not able to offer cover for domestice assistance services under this policy. Please contact our office if you would like a separate policy for this work"
Home Maintenance
Car washing
Pool maintenance
Green Rubbish Removal
Safety and Security
Handyman - Minor Repairs
Gardening
Lawn Moving
Other
Please detail other services provided
"Unfortunatley we are not able to offer cover for home maintainace services under this policy. Please contact our office if you would like a separate policy for this work"
Social & Lifestyle Support
Accompany to appointments
Companionship
Accompany to shopping
Home Admin
Please provide details
Accompany to social activities
Transport
Community programs
Other
Please detail other services provided
Allied health/Therapy
Counselling
Dietician
Physiotherapy
Exercise physiology
Podiatry
Occupational therapy
Psychology
Speech Therapy
Other
Please detail other services provided
Do you hold industry recognised qualifications for the modalities/activities you require cover for?
Yes
No
Additional Therapies - Please tick if cover is required
Pellowah
Biofeedback
Bowen Therapy
Kinesiology
Ear candling
Reflexology
Light touch
Colour and vibration therapy
Systemic constellations
Ayureveda
Tapping
Qi Gong
Crystal healing
Somatic Experiencing Practitioner (SEP)
Craniosacral Therapist (Diploma in Craniosacral Therapy)
Herbal medicine
Animal therapy (non equine or dogs)
Business management counselling
Career counselling
Do You hold industry recognised and relevant qualifications (minimum of 50 hours study) for all activities You have selected above requiring Cover?
Yes
No
Provide details of qualifications
Other Activities
Do you provide any other services, modalities, activities not listed above and for which You require cover for ?
Yes
No
Please detail other services provided
Do you conduct, manage or provide workshops with over 20 participants at any given time?
Yes
No
Do you conduct, manage or provide retreats / provide accommodation / overnight stays ?
Yes
No
"Unfortunatley we are not able to offer cover for retreats, accommodation, overnight stays under this policy. Please contact our office if you would like a separate policy for this work"
Do you sell, supply, distribute, manufacture, licence goods or products OTHER than books, magazines, written or online material relating to counselling services ?
Yes
No
Please describe nature of such goods or products
Do any of the activities You undertake involve invasive procedures or piercing of skin?
Yes
No
Provide details
General Questions
Other than administration support or student practitioners, do you employ or contract other profesional practitioners that you require cover for?
Yes
No
Please describe details
Do you conduct any part of your practice in USA/Canada?
Yes
No
"Unfortunatley we are not able to offer cover for USA/Canada under this policy"
Your Email address
Re-enter Email address
Your Contact Phone Number
Your Postode
Are you a small business eligible for the exemption from the requirement to pay NSW duty on certain types of insurance? Generally speaking, you are a small business if your aggregated turnover is less than $2million. For more information visit
www.revenue.nsw.gov.au/taxes/insurance/exemptions
.