Participant Intake Form
$24.99
Instant download. One-time purchase. Fully editable Word (DOCX).
An editable NDIS participant intake form, completed by a worker during or straight after the intake assessment. It collects what the business needs to decide whether it can support the person and to set up services.
What is inside:
- Participant details, including preferred name and pronouns
- Emergency contacts, advocate, and legal representative or nominee
- NDIS plan dates, plan management type, plan manager, support coordinator and funded categories
- Support needs, plan goals in the participant's own words, and current providers
- Communication and cultural needs, including interpreter and preferred worker gender
- Health and safety: conditions, medication summary, allergies, behaviour support plan and restrictive practices
- Consent and privacy acknowledgement with signatures
- Intake decision: accept, waitlist or unable to accept, with reasons
Good to know: give the participant your privacy collection notice before you complete the form.
- Reviewed against the current NDIS Rules, Practice Standards and Commission guidance
- Editable DOCX with a placeholder legend, so you enter your details once
- Instant download
These templates are general information, not legal advice. No template can guarantee registration or audit outcomes.
Buying more than one template? This one is also in
On its own this template is $24.99. Each pack below includes it, plus the rest of the set.
Digital product. Because these are instant downloads, we do not offer refunds for change of mind once your files have been accessed. This does not affect your rights under the Australian Consumer Law. Bought the wrong pack? Contact us within 30 days and we will credit what you paid towards the right one. If you have a technical issue accessing your files, contact us and we will sort it out. See our refund policy.
Your responsibility. These are editable templates provided as a starting point, not legal, compliance or professional advice. You are responsible for reviewing each template, adapting it to your service, and making sure the information is current, accurate and appropriate for your circumstances and your state or territory before you rely on it. Moreton Regional Support Services is not liable for any loss, penalty or outcome arising from your use of these templates, and no template can guarantee NDIS registration, audit or compliance outcomes.
Add-on modules and other packs
Add only what you deliver. Every pack drops into the same document system, so you can extend your library as your scope grows.
Independent Support Worker Verification Pack$249View packNDIS Provider Core Library$599View packSIL Supplementary Module Add-On$149View packComplete NDIS Provider Document Library$1,099View packHigh Intensity Supports Add-On Module$199View packNDIS Employer Essentials Pack$149View packBusiness Extras Pack$129View packBehaviour Support Add-On Module$149View pack