Plan Management Sign Up | Soothing Minds Plan Management

First Name*

Middle Name(s)

Last Name*

Date of Birth*

Street Address*

Suburb*

State*

Postal Code*

Email Adress

Contact Number*

Do you have a Plan Nominee? Only the Nominee can sign the Service Agreement. The Nominee may either be yourself (the participant) or an individual who is legally appointed to act on your behalf, regarding your NDIS Plan (eg parent/guardian/career).*

Yes

No

Contact Name*

Email Address

Mobile

Preferred Contact Method:

Phone

SMS

Email

Any is fine

What is their relationship to you?*

Parent

Spouse/Family Member

Guardian/Authorised Representative

What is their relationship to you?*

Parent

Spouse/Family Member

Guardian/Authorised Representative

N/A

If you are able to provide guardianship documentation, please provide it here.

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 128 MB.

Will you need to share your NDIS plan information with additional parties such as your parents/guardian, close friends, Support Coordinators or others?*

Yes

No

If Yes, we will follow up with ‘consent to share’ documentation
If No, we will only share information with you personally

Must start with 43*

Plan Start Date*

Plan End Date*

PLEASE UPLOAD A COPY OF YOUR NDIS PLAN

Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 10 MB.

Additional Notes

How did you hear about us?*

NDIS Audit

I do not wish to be part of the audit process.

Do you wish to approve invoices

Yes

No

How was your previous NDIS plan managed?

This is my first NDIS plan

Agency Managed

Self Managed

Plan Managed by another provider

If you were plan managed by another provider, who was the provider?