Plan Management Registration

NDIS Plan Management Client Form

1. Personal Information

2. Contact Information

3. NDIS Plan Management Consent*

Scope of Services:
- Assist in understanding NDIS plan and budget
- Identify and source appropriate NDIS providers
- Manage booking and coordination of NDIS supports
- Submit claims to the NDIA on behalf of the participant
- Monitor plan expenditure

Information Sharing and Confidentiality:
- Maintain confidentiality of participant's information
- Only share information with authorized third parties

Decision-Making:
Participant retains ultimate decision-making authority
Service provider respects participant's choices and preferences

Right to Withdraw Consent:
Participant can withdraw consent for plan management at any time

Dispute Resolution:
Address concerns through open communication and negotiation

4. Consent to Manage Funding and Make Payments

Participant Responsibilities:
- Understanding your NDIS plan
- Providing clear instructions
- Authorizing payments / invoices
- Maintaining records
- Informing the plan manager of any changes in the plan
- Provide the allied health service providers service agreement

Plan Manager Responsibilities:
- Following your NDIS plan
- Managing your NDIS funds
- Making payments to providers
- Providing financial reports
- Maintaining accurate records
- Complying with NDIS regulations

Participant Declaration:
- I declare that the information provided is accurate and complete
- I have received the services listed and understand these claims will be submitted to the NDIS on my behalf
- I give consent for my NDIS plan to be managed and for payments to be made on my behalf as outlined in this form