PLAN MANAGEMENT SERVICE AGREEMENT

    Email: pm@planguard.com.au

    PARTIES

    This Service Agreement is for a participant in the National Disability Insurance Scheme (Participant)

    And: Plan Guard Plan Managers (Plan Guard)

    Plan Guard is a registered provider of supports under the National Disability Insurance Scheme (NDIS). Plan Guard is an intermediary service that will help you manage your NDIS budget and its outcomes.

    PARTICIPANT INFORMATION

    Participant’s Full Name

    Participant’s Address

    Date of Birth

    NDIS Number

    Plan Start & End Dates

    Start: End:

    Name of Plan Nominee or Authorised Representative (if applicable)

    Phone / Mobile

    Email for PM Portal Access and Monthly Statements

    Would you like to approve invoices prior to submission?

    If YES, provide approval email

    Support Coordinator’s details (Name, Phone & Email)

    Do you give consent for your Support Coordinator to access PM Portal & Monthly Statements?

    NDIS Registered providers are required to be audited against the NDIS practice standards as part of the NDIS Quality and Safeguarding Framework. Clients of Plan Guard are automatically enrolled in the audit processes and may be contacted by the (Plan Guard) audit team for interviews and/or have their files reviewed to ensure Plan Guard and our services are complaint. If you do not wish to participant in the audit you can opt out of the process by ticking the box below:

    AGREEMENT CONFIRMATION

    I have read and understood the Plan Guard Service Agreement.

    Signature of participant or representative

    Name of Participant or Representative


    If you have an electronic copy of NDIS plan please attach here (optional):


    FOR PROCESSING BY PLAN MANAGER

    (Once confirmed and signed, a copy of the service agreement will be sent to your email by the plan manager.)

    Signature of Plan Guard representative

    --

    Name of Plan Guard representative

    --

    Today’s Date:

    or Download fill and email the service agreement to pm@planguard.com.au

    Download