QikKids Health Check Services for Centres - Childcare Management Software | CCSS Compliance

AUTHORISED Primary Contact Point

First Name*

Last Name*

Position*

Email Address*

Phone Number (incl. Area Code)*

SERVICE DETAILS (PLEASE PROVIDE THE NAME OF AT LEAST 1 SERVICE REQUIRING A HEALTH CHECK)

Service Name*

Support ID of 1 service on database*

Service Type

SERVICE TYPE

I REQUEST THE FOLLOWING REVIEW (CHARGED PER SERVICE)

Under 50 licenced placed service - $299
50 - 89 licenced placed service - $399
90 - 119 licenced placed service - $499
120+ licenced placed service - $599

Number of services requiring review*

Charges above are at a per service basis, If you have multiple services you would like reviewed please
add details to the comments area below.

Comments

Authorisation of Admin User *

I authorise for a new Administration user to be set up to access my database for the purposes of the QK Health Check and authorise for this user to be used for this purpose only. On completion of the Health Check the user will be locked out of the database to prevent any further access. If the Health Check results in additional work to be done through this user account, I will be further notified and updated.

Accept Authorisation Conditions

Accept Authorisation Conditions

Authorise Access Report *

I acknowledge that QK Technologies and it's authorised partners will access and report on my service/s as described in the QK Health Check overview and I will be provided with a report on my service/s detailing all outcomes.

Accept Access to Reports

Accept Access to Reports

I Accept Terms and Conditions *

I Accept Terms and Conditions

Yes

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