Tick one Sample Clauses
The "Tick one" clause is used to require a party to make a specific selection from a set of predefined options within a contract or form. In practice, this clause is often presented as a list of checkboxes or radio buttons, where the party must indicate their choice by marking the appropriate box. This mechanism ensures that the party's preference or agreement to a particular term is clearly indicated, thereby reducing ambiguity and ensuring that both parties understand which option has been selected.
Tick one. The boarding room which the tenant is renting is not shared by other tenants. The boarding room which the tenant is renting is shared by other tenants and the maximum number of other tenants who may occupy the room is .
Tick one. This boarding house tenancy is a joint tenancy with . This boarding house tenancy is not a joint tenancy.
Tick one. ❑ Yes as a first treatment If yes, how many times? (not more than 9) ❑ Yes only if other treatments have not worked If yes, how many times? (not more than 9) ❑ No Signature: Date: Name: Signature: Date: Name: Signature: Date: Name: ❑ I am satisfied that the person has decision-making capacity to fill in this form and that the matters discussed and agreed to in the form are within my professional scope of practice. Signature: Date: Contact details: Name: Signature: Date: Name: Signature: Date: Did you sign this form? Nominated person – signature on Page 4 Yes / No Advance Agreement – signatures on Page 10 Yes / No Advance Consent Direction – signatures on Page 15 Yes / No Once your Form Kit is signed, you must give a copy to: You Yes / No Your Nominated Person, if you have one Yes / No Your Guardian, if you have one Yes / No Your Power of Attorney, if you have one Yes / No Any clinician who can access your health information Yes / No Any clinician who can’t access your health information Yes / No You may want to give the Form Kit to: Your Carer, if you have one Yes / No Other people who are helping you Yes / No If you are not a patient at Canberra Health Services Mental Health, Justice Health and Alcohol and Drugs Service (MHJHADS), you can email it to ▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇▇.▇▇. They will add it to Canberra Health Services system. Yes / No Other – Name: Yes / No Other – Name: Yes / No Other – Name: Yes / No Your Nominated Person, Advance Agreement or Advance Consent Direction is legal until it is cancelled or changed. This Form Kit has your views, wishes and decisions. Read this Form Kit at least once a year to see if you want to change it.
Tick one. Will you be using subcontractors for any part of your contracted work? ☐ Yes ☐ No Write the business name of any subcontractors being used by PCBU2. As evidence of due diligence, attach a copy of your Subcontractor’s SSSP Agreement section, to the back of this SSSP either now or when the Subcontractor begins work on this site. Kākāriki (Green) Agreement SSSP Form 1 3 Outline of work being undertaken Write a brief outline of the scope of work this SSSP relates to.
Tick one. ✔ The boarding room which the tenant is renting is not shared by other tenants.