SUPPORT COORDINATOR

I am a Support Coordinator

I am a Support Coordinator and would like to sign my client up for Plan Management

Consent *

I declare I have been provided with written consent from the NDIS Participant, their Parent or Guardian to sign this agreement and this consent has not been revoked.

Participant's Details

First Name

Last Name

Date of birth

Gender:

Phone *

Email *

Address

Street Address

City

State

Postal code

NDIS Plan Details

Participant NDIS Number *

Total $ Value of the Plan Managed Support Budgets *

Plan Start Date

Plan End Date *

Ongoing Consent

This question is asking if you would like Find Wellbeing to automatically continue managing your NDIS plan if it is reviewed or renewed in the future. This means that if your NDIS plan is extended or a new one starts, Find Wellbeing would keep managing it without needing new consent each time. However, both you and Find Wellbeing can still end this service agreement at any time according to the terms and conditions in the 'Ending this service agreement' section.

Do you give Find Wellbeing consent to continue managing your plan should it be reviewed and for subsequent plans? *

YES

Budget App - Invoice Approvals & Rejections

The Participant like to use the budget app to approve or reject provider invoice. *

YES

All invoices must be reviewed within a 3-day period; otherwise, they will be automatically

Attach NDIS Plan

This plan will not be shared with any third party without prior consent.

Upload a copy of the NDIS plan *

Terms and Conditions

Yes, I agree with Terms and Conditions.

Submission

The individual completing this agreement to be authorised must be authorised signee.

Submitted Date *

Signature_NDIS Participant *

Clear

The individual completing this agreement must be the authorised signee