We’ve recently made a few updates to our services. Please call our friendly plan management team on 1800 954 559 or email support@ndism.com.au and we'll be happy to assist you.
Participant Name
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First Name
Last Name
NDIS Number
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Participant's date of birth
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Day
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Month
Year
Email Receipt
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example@example.com
Nominee Name - If Applicable
First Name
Last Name
By signing this form, I acknowledge and agree that:
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I give consent for Independent Support Management (ISM) to process Priority Payment Requests from my service providers.
The Priority Payment Service is optional and available to providers who require faster invoice processing.
A 4% Priority Processing Fee applies and is charged directly to the service provider.
This fee is deducted from the provider’s invoice amount before payment is made.
The 4% fee is NOT added on top of the invoice total and does NOT come out of my NDIS Plan Funds.
ISM will send me a copy of any invoices processed under the Priority Payment Service for my review and record-keeping.
I can withdraw my consent and terminate this agreement at any time by contacting ISM.
Approved start date
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Day
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Month
Year
Participant/Nominee Signature
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Use your mouse or finger to draw your signature above
Name of Signatory
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First Name
Last Name
Should be Empty: