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ABN: 64 640 207 469MY PLAN SUPPORT SERVICE AGREEMENT This Service Agreement is between My Plan Support Agency and the Par giant/nominated represent ave in the Na oral Disability Insurance Scheme.
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Start by collecting the necessary personal information of the participant, such as their full name, date of birth, and contact details.
02
Identify the authorized representative who will be filling out the information on behalf of the participant.
03
Enter the authorized representative's full name, relationship to the participant, and their contact information.
04
Include any required identification or documentation that verifies the authorized representative's rights to act on the participant's behalf.
05
Review all entered information for accuracy and completeness before submission.
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Sign and date the form as required to validate the information provided.

Who needs participant information authorised representative?

01
Participants in programs or studies that require additional support or representation.
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Individuals who are unable to complete the participant information themselves due to age, disability, or other reasons.
03
Legal guardians or caregivers needing to submit information on behalf of minors or individuals with disabilities.
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A participant information authorised representative is an individual or entity designated to act on behalf of a participant in matters related to their information or benefits.
Entities or individuals who manage participant benefits or information, such as plan administrators or third-party administrators, are required to file participant information authorised representative.
To fill out the participant information authorised representative form, provide all required personal information of the participant and the representative, including names, addresses, and any necessary identification numbers.
The purpose of the participant information authorised representative is to ensure that a designated individual or entity can legally access and manage a participant's information and benefits.
Information that must be reported includes the participant's name, contact information, the representative's name, contact information, and the nature of the authority granted.
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NDIS My Plan Support Service Agreement Disability Support Plan Management Budget Management Participant Responsibilities Privacy Act Feedback and Complaints Support Coordinator

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