**Please be sure to complete the forms in all 5 boxes.
Fee Structure
Initial amount of R 24,000 (plus VAT) is payable prior to commencement of the residents programme, acceptance will be confirmed on receipt of proof of payment.
Balance due of R 24,000 (plus VAT) is payable 90 days into the initial 6 month programme, you will be invoiced.
In the event of the applicant leaving, absconding, or in extreme cases, being expelled, programme or related fees will be forfeited. Please note that we do not endorse a quick-fix approach to recovery and sponsors are required to be able to commit financially with regards to the completion of treatment, which could take up to a year. In light of the above, it is required that both residents and sponsors commit for a minimum period of 6 months.
Should a resident relapse whilst off Healing Wings South Africa premises, he/she has a period of 48 hours to return willingly. Failure to do this
will require the resident to reapply and be readmitted to Healing Wings and all fees paid will be forfeited.
Please note that by signing this document you are attesting to being made aware of the prospective resident’s application and the information relating to fees and fee structure. You will only be liable for the above-mentioned fees upon confirmation that the respective resident has been accepted and will be attending Healing Wings South Africa.
<strong>Includes</strong>
Treatment programme, board and lodging
Initial travel expense from Nelspruit Bus Terminus to Healing Wings South Africa, provided residents arrival corresponds with one of our scheduled trips to Nelspruit. Extra trips arranged will be charged to the resident. New residents flying are liable to pay a collection fee of R480.00 to be collected from the Kruger Mpumalanga Airport.
<strong>Does not include</strong>
Money for tuck shop – maximum R1000 per month.
Telephone calls made on behalf of intakes, and all additional trips outside of the centre.
Travel expenses to Nelspruit and return for holiday and/or other business.
<strong>Medical Expenses</strong>
<strong></strong>A mandatory non-refundable medical levy of R1, 000.00 per resident is payable and will be invoiced for together with initial fees. This money will be used to cover basic and unforeseen medical costs (incl basic first aid, drug testing etc). Basic and first aid medication will be charge for on a per item basis. Sponsors will be required to replenish this levy, once the funds have been used for medical purposes.
Trips to medical and other institution s for appointments and the like will be charged for at a minimum cost of R150.00 per trip – funds not deposited prior to the trip will be deducted from a resident’s medical or tuck shop account.
Payments for all medical appointments made on the residents behalf (or any emergency procedures), are payable directly to the medical professional or institution. Contact and payment details will be supplied on confirmation of the appointment. Kindly note that Healing Wings will not pay any medical professional or institution on a resident’s behalf.
Medical Aid – Please note that Healing Wings South Africa does not claim directly from any medical aid scheme. Residents are required to pay Healing Wings South Africa and to then claim back form their medical aid on receipt of an official Healing Wings invoice
Proof of payment must be submitted with specific details pertaining to payment, i.e. stating resident name and purpose: fees or tuck shop money. Please note that tuck shop money will be withheld in the event of late payment of fees. Kindly note that a bank charge fee of R200.00 will be charged an all fees paid by cheque.
<strong>Banking Details</strong>
Account Name: Healing Wings South Africa
Bank: First National Bank
Branch: Nelspruit
Branch code: 256405
Account Number: 62238898467
VAT Reg no: 4590255016
I understand that the fees are payable in advance, tuck shop and medical accounts are non-refundable. Should the resident leave for any reason whatsoever, including but not limited to expulsion, prior to the programme being completed, no monies will be refunded. Healing Wings South Africa reserves the right to claim recovery of any amount still outstanding, notwithstanding the early termination thereof. I further understand that Healing Wings South Africa in no way takes responsibility for non-payment of any Medical Aid claim for Treatment Invoices. I hereby agree and will abide by the above conditions:
<strong>Disclaimer</strong>
By ticking this box, I hereby confirm that all information disclosed on this document is (to my knowledge) 100% correct and accurate and that I have not failed to disclose or include any information which may prove vital.
Medical
A thorough medical assessment is carried out by our registered professional nurse, within 24 hours of arrival.
Healing Wings utilizes the services of a medical doctor practising in Nelspruit who is on call on a 24 hour basis. Our referring Psychiatrist, based in Nelspruit, assesses and treats all residents in need of psychiatric care. We require that all medical and dental needs are attended to prior to admission to Healing Wings. Please ensure that you bring at least one months’ supply of your prescribed medication.
Please note that all residents on prescription medication need to supply Healing Wings with a copy of their prescription for a repeat period of 6 months, prior to arrival. This prescription is to be accompanied by a medical report/letter from the residents prescribing Dr. Healing Wings South Africa cannot issue medication without a copy of the prescription.
A mandatory non-refundable medical levy of R1, 000.00 per resident is payable and will be invoiced for, together with initial fees. This money will be used to cover basic and unforeseen medical costs (incl basic first aid, drug testing and medical emergencies, where the parents or guardian cannot be notified of expenses before they are incurred).
o Basic and first aid medication will be charge for on a per item basis. Sponsors will be required to replenish this levy, once the funds have been used for medical purposes.
Trips to medical and other institution’s for appointments and the like will be charged for at a minimum cost of R150.00 per trip – funds not deposited prior to the trip will be deducted from a residents medical or tuck shop account (should the medical account be depleted)
The medical fund is for emergencies, unforeseen and on site minor ailment medical care only. Payments for all medical appointments made on the residents behalf (or any specialist appointments and procedures), are payable directly to the medical professional or institution. Contact and payment details will be supplied on confirmation of the appointment. Kindly note that Healing Wings will not pay any medical professional or institution on a resident’s behalf.
Should a resident’s medical account reach an amount of R500.00, notification will be given for it to be replenished. Any monies deposited in respect of tuck shop will be allocated to a resident’s medical account first, Should that account be depleted.
Pharmacy account: please note that prior to arrival, all residents need to have an account opened at a pharmacy in Nelspruit – this is for the supply of prescription, over the counter or other medication. Healing Wings South Africa (including a resident’s medical fund) will not be responsible nor will we be held liable for the purchasing of a residents medication. The parent or sponsor will be required to supply Healing Wings with an account number at your chosen pharmacy. Should, at any time, funds not be available in the pharmacy account, Healing Wings will not be responsible for the purchase of a residents medication. Herewith, please see contact details of pharmacies in:
Nelspruit
o Mopani Pharmacy: (013) 755 5500 (please speak to Jolene)
o Clicks Pharmacy – Riverside Mall, Riverside Park: (013) 7570184
o Dischem Pharmacy – The Grove, Riverside Park: (013) 757-9383
Medical Aid – Please note that Healing Wings South Africa does not claim directly from any medical aid scheme.
Residents are required to pay Healing Wings South Africa and to then claim back form their medical aid on receipt of an official Healing Wings invoice. It is advisable to contact your Medical aid and obtain pre-authorisation before admission to Healing Wings (this will ensure a smooth processing of your claim and reimbursement).
Please quote the Healing Wings practice number 0380091 when obtaining pre-authorisation.
I understand and accept the terms and conditions with regards to Healing Wings South Africa medical centre protocol.
Personal Medical Information
Please note that all medication (including schedule 0 – Paracetamol, ointments, spasmol, vitamins etc.) brought in with resident require the following information labelled from the pharmacy or prescribing doctor:
Patient Name
Method of use
Name of prescribing and dispensing Doctor/pharmacist
Rules & Regulations
You must have a willingness to achieve recovery. This is a process that takes time and you are encouraged to complete the programme.
You will adhere to the authority and rules laid down by Healing Wings South Africa.
Drugs and alcohol are prohibited. Persons and luggage will be searched on arrival and random searches and drug testing will be carried out.
All monies, cell phones and medication are to be handed in on arrival.
All activities- allocated work therapy, daily routine, meetings and meals are compulsory.
If you damage the property and assets you will be held accountable for damages.
You may not leave the property without obtaining consent from the management. Walking alone around the centre is prohibited. Demarcated areas are out of bounds.
Allocated duties- bedrooms, ablution block and surrounding environment must be kept clean, neat and tidy at all times.
If you leave or abscond, or in extreme cases being expelled, programme and related fees will be forfeited.
Should a resident abscond from the Healing Wings programme, all valuable and personal effects (i.e. wallet, cellphone etc) will NOT be handed to individual on departure – personal items will be mailed to the individuals sponsor/family directly.
Healing Wings South Africa will not be held responsible for any property left behind by the resident.
You may receive letters and e-mails once a week from direct family.
Romantic relationships between residents will not be tolerated under any circumstances.
Telephone calls are a privilege earned on merit. This will be determined after the first month. During the first month no telephonic or written contact will be allowed. After the initial month, a fixed time slot (10 minutes per week) will allocated on a specific day, during which you may be contacted.
Visitations are strictly earned on merit (this will be determined after the first 3 months), and the decision will be made only after consultation between management and parents/sponsors, and will depend on your progress at the time. The first visitation is for family members only as we focus on restoration within the family unit.
Parents, sponsors or legal guardians are welcome to contact the assigned counsellor for feedback with regards to progress.
Written progress reports will be sent by the relevant counsellor on completion of every 3- month cycle by the resident, and thereafter upon departure from Healing Wings South Arica. Should you leave prior to completion of treatment, against counsel; a report to this effect will be forwarded to those concerned.
Please note that all correspondence concerning former relationships or current partners will be discerned accordingly by management.
Parcels may be sent via regular postal services or private courier services e.g. XPS, Sun Couriers etc. Mark parcels clearly with the residents name. XPS have pre-paid, 5 kg sized boxes for sale. They will collect these pre-paid parcels from your home or business and deliver the next day by 17:00 to Nelspruit. The contact number is 0860-000-977. Parcels delivered to the post office before 16:00 can also be sent with their overnight delivery service on request.
Post Office: Healing Wings, Private Bag X 11340, Suite# 426, Nelspruit 1200.
Courier services: ( Physical Address): Healing Wings c/o 3@1, Suite #426, Shop 52A, Riverside Mall, Riverside Park, Nelspruit, 1200, Phone 013- 757 0269, Fax 013- 757 0017. (parcels maximum of 8 kg)
