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Sign Up Form
Become plan-managed by SPM
Before you begin, please
read our Service Agreement
.
"
*
" indicates required fields
The Participant
Name
*
First
Surname
Date of Birth
*
Day
Month
Year
Gender
*
Female
Male
Non-Binary
Other
Address
*
Street Address
Street Address Line 2
City/Suburb
State
Postcode
Contact Number
*
Email
*
NDIS Number
*
Participant's Contact Representative
The following fields refer to the participant's contact representative - a nominee.
Name
First
Surname
Contact Number
Email
Support Coordinator
The following fields refer to the participant's support coordinator.
Name
First
Surname
Organisation
Contact Number
Email
NDIS Plan
Plan Start Date
Day
Month
Year
Plan End Date
Day
Month
Year
Service Agreement to continue unless terminated by either party.
Please upload a copy of the Participant's NDIS plan
*
Accepted file types: pdf, doc, docx, Max. file size: 3 MB.
Preferences
Who is your preferred contact person?
*
Participant
Contact Representative (Nominee)
Support Coordinator
What is this contact person's preferred method of contact?
*
Phone Call
Text Message
Email
Post
Other
Would you like to approve invoices?
*
Yes
No
Would you like to have a login to our portal?
*
Yes
No
By accessing our real-time portal, you’ll be able to easily track your spending and NDIS funds.
How would you like to receive statements?
*
Email
Post
Terms
Service Agreement
*
I have read the
Service Agreement
and accept the terms.
By ticking this box, you state you have read and accept the Service Agreement terms, or have gained consent on behalf of the participant and/or support coordinator.
Almost there!
How did you find out about Shoalhaven Plan Management?
Referral
Google Search
Social Media
Other