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Become a Participant

    Personal Information







    Address















    Accommodation




    Communication Preferences


    Your Goals


    Supports you request from HDS


    When would you like to request supports with HDS










    Your Support Needs

    How you manage everyday tasks:

    Please tell us about your ability with the tasks listed below.




















    Your Healthcare needs

    Your health care needs:


    Plans or Reports

    Have you completed or have any of the plans listed below?



    Risk Assessment

    This section requires you to disclose any significant risks that may relate to your supports requested.




    Current Living Arrangements


    Your Decision Making - Informal

    This section asks about your advocate, family member, friend etc. (NOT Formal Guardian)


    If Yes, what are their details?






    Guardianship Functions

    This section asks about details of any formal guardianship orders you have in place


    If Yes, what are their details?






    Financial Management

    This section asks about details of any formal financial management you have in place


    If Yes, what are their details?





    NDIS - Coordination of Supports

    If you have a current Coordinator of Supports, please record their details below

    Name





    Completing this form

    Did you require assistance completing this form?

    If so, please record the details of the person whom completed it.

    Name