Support Coordinator - Allocated Budget Notification Form

Support Coordinator - Allocated Budget Notification

This form is used to advise Click Plan Management of current service agreements in place with Providers. Click Plan Management will create specific allocated budgets based on this information for better monitoring of spending for your participants.
Support Coordinator - Full Name*

First NameLast Name
Company Name
Email Address*
example@example.com
Phone Number
Please enter a valid phone number.
Participant's Name*

First NameLast Name
NDIS Number*
Date of Birth*

DayMonthYear
Date
Plan Start Date*

DayMonthYear
Date
Plan End Date*

DayMonthYear
Date
At Click we understand how hard it can be to monitor spending by Providers. To make this process very easy we are able to allocate specific budgets for providers based on your participant's service agreement in place with them or the amount that your participant wishes to spend with that particular organisation.

It is important to ensure that service agreements that your participant enters into do not exceed the budgets within their NDIS plan, this is to ensure that the funds will be sufficient for the full duration of the plan.

Once these budgets are allocated on our system they can then be tracked via our portal, your participant can also track this on their app.
Advice of Current Service Agreements With Providers

Please complete the below table based on current service agreements with your participants providers.

Allocation of Budgets for Providers e.g. Happy Services Inc - Core Assist with Daily Life (01) - $25199.00, Happy Services Inc - CB Increased Social and Comm (09) - $3583.63

	My Service Provider	Type of Supports Provided	Amount to Allocate $	Service Agreement Start Date	Service Agreement End Date
1
2
3
4
5
6
7
8
9
10

Disclaimer: Click Plan Management can only allocate funding to providers within our own internal IT systems for tracking. There can be many reasons that change the available funding which are outside of our control, therefore we cannot guarantee that funds will be available. We do not accept any liability for any overspending in a participants plan. When submitting we will ensure to inform the appropriate person at that time if there are insufficient funds available.
File Upload Area

If you are happy to provide copies of your agreements these can be uploaded below and will be kept on your file safely and securely.
Provider 1 - Service Agreement (upload electronic copy of agreement)

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Provider 2 - Service Agreement (upload electronic copy of agreement)

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Provider 3 - Service Agreement (upload electronic copy of agreement)

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Provider 4 - Service Agreement (upload electronic copy of agreement)

Cancelof
Provider 5 - Service Agreement (upload electronic copy of agreement)

Cancelof
Provider 6 - Service Agreement (upload electronic copy of agreement)

Cancelof
Additional Comments
Should be Empty:

Support Coordinator - Allocated Budget Notification

Advice of Current Service Agreements With Providers

File Upload Area