Full scorecard

Complete the full intake.

Your scorecard is built from these answers, so this form goes into more detail. Have your provider details, your deadline, your policy list, a register or HR sample and your evidence list to hand.

Where something does not exist or cannot be checked, the honest answer is Not available or Unsure. Use the records you already keep, and do not write anything new for this form.

Send redacted samples only, with participant names, NDIS numbers, diagnoses, clinical notes, incident narratives and worker personal details taken out. When we confirm your intake is complete, your report follows within 48 hours.

See the sample report

1. Contact and authority

provider or trading name *

primary contact *

contact role *

email *

preferred clarification channel

If you choose phone, we will offer a time by email first.

I have authority to share the supplied material for this diagnostic. *

I will send redacted copies with identifying details removed, and follow any secure handling steps Clearharbour sends me. *

2. Provider and scope

3. Dates and reason

audit or renewal date *

known registration or application deadline *

deadline pressure *

main reason for requesting the scorecard *

registration, audit or deadline correspondence

Optional. Upload a redacted copy above, or paste a secure link you control, such as a shared drive link set to expire.

4. Evidence and documentation status

No incidents yet still means you need an incident process.

policy index and representative policies *

incident register *

complaint and feedback register *

risk register *

worker screening and HR records *

records showing incidents and complaints being handled *

an evidence index or folder map an auditor could follow *

5. Secure material handoff

material available for secure handoff *

registration, audit or deadline correspondence policy index and representative samples sample register entries, or blank register templates worker screening / HR index incident/complaint process and examples evidence index or folder map None available other

Tick all that apply. Tick None available if nothing is ready.

secure materials upload

secure link you control

If you tick anything other than None available, add a file or a secure link you control. We can't mark the intake complete without it. How we handle what you send us.

6. Context and debrief

what should we know

anything you want the written debrief to focus on (optional)

Before you submit

Do not upload participant names, NDIS numbers, diagnoses, clinical notes, incident narratives or worker personal details. If a document does not exist, select Not available. There is no need to create one for this form.