THUS Schedule of Supports
Important Information
They require the NDIS Support Item and Reference Number for the services you’re providing so they can reserve funds for your services in the participant’s budget. If you do not know the name or reference number, please refer to the NDIS Pricing Arrangements.
Please complete each of the columns below and submit this document to the plan-manager prior to submitting your invoices.
If during the course of your agreed upon contract with the Participant any of the information below changes, please notify the plan-manager by submitting a revised Schedule of Support document so that they may appropriately update their systems.
For the fastest processing of this document – make sure you are sending it directly to the correct email address for the specific plan-manager.
Parties
Provider Trading Name:
Provider ABN:
Participant Full Name:
Participant NDIA Number:
Participant or Nominee Signature:
Date:
-
Day
-
Month
Year
Date
Schedule of Support
Support 1.
NDIS Support Item Name:
NDIS Support Item Reference No:
Number of Units/Hours:
Cost Per Unit:
Start Date:
-
Day
-
Month
Year
Date
End Date:
-
Day
-
Month
Year
Date
Total For Service:
$
Support 2.
NDIS Support Item Name:
NDIS Support Item Reference No:
Number of Units/Hours:
Cost Per Unit:
Start Date:
-
Day
-
Month
Year
Date
End Date:
-
Day
-
Month
Year
Date
Total For Service:
$
Support 3.
NDIS Support Item Name:
NDIS Support Item Reference No:
Number of Units/Hours:
Cost Per Unit:
Start Date:
-
Day
-
Month
Year
Date
End Date:
-
Day
-
Month
Year
Date
Total For Service:
$
Total For All Supports:
$
Participant or Nominee Signature:
Date:
-
Day
-
Month
Year
Date
Submit Form
Submit Form
Should be Empty: