Participant Intake Form

1. Participant Details

What services you require from us?
MM slash DD slash YYYY
MM slash DD slash YYYY
Gender(Required)

Contact details

Interpreter required(Required)
Preferred option for communication(Required)
Do you identify as Aboriginal and Torres Strait Islander?(Required)
Residential Address(Required)
Is there a Guardianship and/or Administration order in place?(Required)

2. Disability / Medical Conditions

Disability / Medical Conditions including any diagnosis if relevant.

3. Funding

Funding Source(Required)

4. Preferences

5. Goals and Aspirations

I understand that:

How did you hear about us?(Required)
Information(Required)
Information(Required)
Information(Required)

About the NDIS

The National Disability Insurance Scheme (NDIS) is a new way of providing support for Australians under the age of 65, with a significant and permanent disability, as well as providing support to their families and carers. The scheme takes a lifetime approach to ensuring that Australians with disability will have the necessary support they need to live an ordinary life.

If you are eligible, the NDIS will provide funding for reasonable and necessary supports that are required for you to live your life and reach your goals in your NDIS plan.

NDIS Funding

Understanding the Price Guide is a resource developed by the NDIS.

This explains key changes in the Price Guide and Support Catalogue and how this might impact you, your family and or carers and your NDIS plan.

It’s important for you to understand all the prices you may be charged for your NDIS supports, so that you can be confident that you are receiving value for money from your allocated funding in your NDIS plan.

Stay up to date with any Price Guide changes here!

Am I Eligible for the NDIS?

You are eligible for the NDIS (National Disability Insurance Scheme) if you:

Age

Under the age of 65

Residence

Live in Australia, Australian citizen, permanent resident or special category visa holder

Permanent Disability

Experiencing a permanent disability that significantly impacts your daily life and activities..

Get Started

Reach out to us!

Our team can assist you with your NDIS journey and can help you with the following:

NDIS application, appeals and reviews

Understanding the funded supports in your NDIS plan

Connecting you with community activities, events or mainstream supports

What is the NDIS
About the NDIS

The National Disability Insurance Scheme (NDIS) is a new way of providing support for Australians under the age of 65, with a significant and permanent disability, as well as providing support to their families and carers. The scheme takes a lifetime approach to ensuring that Australians with disability will have the necessary support they need to live an ordinary life.

If you are eligible, the NDIS will provide funding for reasonable and necessary supports that are required for you to live your life and reach your goals.