NDIS ONLINE ORDER FORM
Thank you for contacting JB Hi-Fi Business. We are delighted to assist you with your purchasing needs under the NDIS and help you with better ways to live, learn, work and play
Client's Full Name:
*
First Name
Last Name
Client's NDIS Number
*
Bill To Address (Plan Manager Details)
*
Street Address
Street Address Line 2
Suburb
State
Zip Code
State
*
Delivery Details:
we do not deliver to PO Box addresses due to security reasons
Delivery Address - Client Address
*
Street Address
Street Address Line 2
Suburb
State
Zip Code
State
*
Client Phone number:
*
Please enter a valid phone number.
Client E-mail:
*
Please include Client/Plan manager/OT email addresses
Optional Email
Please include Client/Plan manager/OT email addresses
Plan Manager Phone number
Please enter a valid phone number.
OT or Coordinator email address (If applicable)
example@example.com
About your order
Please list the items that you wish to order. You will need to include the Product SKU, the model number and how many of each item you require. You can also add a link to the product from the JB Hi-Fi Website. Please do not include your NDIS Number or other personal information in this text box.
Please add all product links from jbhifi.com.au and also QTY details
Next Steps
Once you have submitted this form, one of our JB Hi-Fi Business Account Managers will be in contact with you to provide a pro forma invoice for the requested products. The pro forma invoice contains JB Hi-Fi’s terms and conditions of sale. (Good Money and Good Shepherd clients to contact their provider)
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