Full Name * NDIS Number * Date of Birth Phone Number * Email Address * Residential Address * NDIS Plan Information What type of NDIS plan do you have? * NDIA ManagedPlan ManagedSelf Managed NDIS Plan Start Date NDIS Plan End Date Do you have funding available for Home Maintenance? YesNoUnsure Plan Manager Details (If Applicable) Plan Manager Company Name Plan Manager Contact Person Plan Manager Email Plan Manager Phone Number Service Request Details What maintenance service do you require? Please describe the work required * How urgent is this request? * Low (1–2 weeks)Medium (few days)High / Safety Issue (ASAP) Property Information Is the work required? Inside the HomeOutside the HomeBoth Property access type * Easy accessApartment / stairsGated propertyRural / difficult access Are there any access restrictions? NoYes If yes, please specify Are there stairs at the property? YesNo Is parking available on-site? YesNo Health & Safety Information Are there any known hazards we should be aware of? Heights required (ladder work)Electrical risksWater leakageStructural damageNo known risks If yes, please provide details Are there pets on the property? NoYes If yes, please specify Will a support worker be present? YesNo Who will be present during the service visit? ParticipantFamily MemberSupport WorkerOther 📂 FILE SUBMISSION STATUS – EMAIL & GOOGLE DRIVE Please tick ALL that apply: 📸 I have emailed Photos to hello@hellowhs.com.au🎥 I have emailed Videos to hello@hellowhs.com.au📄 I have emailed NDIS Plan📑 I have emailed Support Documents📁 I have uploaded ALL files to Google Drive and pasted the link below 📁 Google Drive Upload Upload your files to Google Drive and paste the link below: 👉 Open Google Drive Paste your Google Drive link here * ⚠️ Make sure your link is set to "Anyone with the link can view" 📧 Email Option Send files directly to: hello@hellowhs.com.au 👉 Click here to Send Files via Email Please include your Full Name + NDIS Number in the email subject. 🤖 NDIS Intake System Notice Your request will be processed through our NDIS Intake System. We may contact you if additional information is required before quoting. Service Scheduling Preferred Service Date Preferred Time MorningAfternoonFlexible Consent I confirm that the information provided is accurate and complete. I understand this is a request for quotation only and work will not commence until approval is given in accordance with NDIS guidelines.
