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Consent - Do you have Legal Authority to sign up?

Yes, I am the NDIS participant Yes, I am the plan nominee Yes, I have legal consent from the NDIS participant

Participant's Name

First Name

Last Name

Phone Number

Date of Birth

Participant Address

Suburb

State

Postcode

Email Address

Participant NDIS Number

How is NDIS plan managed?

Plan Manager Details (if applicable)

Plan start date

Plan end date

PACE Participant?

How are you associated?

Your Name

First

Last

How did you hear about us?

We will need a copy of your NDIS plan to set you up in our system. Please upload it by clicking the button

Any other information (optional)

Personal Information Collection Statement

To assist us (Enabled Care Pty Ltd - ABN: 54 650 962 637) in conducting our business functions and sending you regular communication, we need to collect personal information about you.

By providing your personal information, you agree to its use and disclosure in accordance with this statement and Privacy Policy. If you do not agree, you must not provide your personal information, and we may not be able to communicate with you or provide certain services to you. We may disclose your personal information to other parties, including our website host or software application provider to operate our website, third parties who provide products and services to us or through us, your authorised representatives/nominees, and representatives, agents or contractors who we appoint in the ordinary operation and administration of our business.

Our Privacy Policy is available here.

It contains information about how you may access and seek correction of your personal information, how you may complain about a breach of your privacy, and how we will deal with that complaint.