About You

Select an option below to get started:

I'm a NDIS Participant and I want to nominate MyLinks as my Plan ManagerI'm a Parent, Plan Nominee or Guardian of a child, aged 17 years and under and I want to nominate MyLinks as my Plan ManagerI'm a Parent, Plan Nominee or Guardian of person, aged 18 years and over and I want to nominate MyLinks as my Plan ManagerI'm a Support Coordinator and I want to nominate MyLinks as my client's Plan Manager

Child Representative - Your Details

Please complete your details below as the Child's Representative

A Child Representative (Plan Nominee) is a person recognised by the NDIA to act on behalf of an NDIS participant due to the participant's age and manage matters related to the participant's NDIS plan.

This is typically a parent or family member or other relative. It can also be legally appointed guardian, such as a Child Safety Officer

First Name

Last Name

Phone Number

Relationship to Particpant

Other (Please Specify)

Plan Nominee - Your Details

Please complete your details below as the Participants Plan Nominee

A Plan Nominee is a person formally recognised by the NDIA to act on behalf of an NDIS participant in matters related to their NDIS plan. They may be appointed at the participant's request or through a legal mechanism such as a court or tribunal order.

A Plan Nominee is typically a family member, such as a parent, step-parent, or other relative or a legally appointed representative, such as a guardian or someone holding Power of Attorney

First Name

Last Name

Phone Number

Relationship to Participant

Other (Please Specify)

Support Coordinator - Your Details

Please complete your deatils below, as the person making the referral of behalf of the participant.

First Name

Last Name

Phone

Company Name

Consent to Act

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Please upload the NDIA's Consent to Act form (if applicable).

Service Agreement

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Please upload a copy of your Service Agreement (if applicable)

Additional InformationAdd further information if required

Is the Participant the point of contact?

Yes; They are able to make their own decisions No; They have a Plan Nominee and/or an appointed legal guardian

Plan Nominee Details

First Name

Last Name

Phone Number

Relationship to Participant

Other (Please Specify)

Participant Details

First Name

Middle Name

Last Name

Preferred Name (Optional)The name you would prefer we use when communicating with you

Date of Birth

Age

Gender

Identify as Aboriginal or Torrs Strait Islander?

YesNoPrefer not to answer

Select Option

Unit/Street Number

Street Address

Suburb

Post Code

State

Phone Number

Would you like to provide an additonal contact number e.g Home Phone?

YesNo

Other

Preferred Method of Contact

Do you require any accessibility accommodations?

YesNo Unsure

Accessibility Options

Easy Read Documents / Voice to Text adaptions Visual Accommodations (e.g Large Print, High Contrast)Hearing Accomodations (e.g. Auslan Services) Other

Preferred Method of Contact

How often would you like to hear from us?

I would like a quarterly (every 3 month) check in e.g Email/Call I will contact the Plan Manager when I need help

NDIS Plan Details

NDIS Number

NDIS Plan Start Date

NDIS Plan End Date

Is this a new NDIS Plan?

YesNo - Changing Plan Managers

Current Plan Manager

Exit Date (If Known)

Copy of NDIS Plan

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I agree that MyLinks can contact me regarding news, updates and annoucmeents that relate to my services with MyLinks and informaiton about changes to the NDIS. I understand that I can view MyLinks privacy policy which explains how I can opt-out at any time.