Access Request Form
Information required to be completed by the Participant:
- Personal Details
- Your privacy and consent to collect and share your information
- How would you like the NDIA to contact you?
- Parent, legal guardian or representative details (if applicable)
- Information about your carers and family members (if applicable)
- Your disability, or need for early intervention supports
- Always list the disability that has the most affect on your daily functional life first.
- Then list the disabilities that affect your functional abilities on a daily basis.
- These need to be listed in order of most affect on your functional abilities on a daily basis to least.
- It is also worth listing major functional limitations (Secondary conditions)
- The section “We need supporting information about your disability and the impact it has on your mobility, communication, social interaction, learning, self-care and/or ability to self-manage.”
- If possible this is best completed by a Professional, for example
- General Practitioner
- Medical Specialist
- Educational Professional, etc