NDIS Order Form - The Sensory Store

It is the responsibility of the purchaser to ensure that all guidelines have been abided by as per the NDIS Funding Criteria. Higher risk assistive technology products, including weighted blankets, compression sheets (bed socks) and therapy balls will require written advice from a registered Allied Health Practitioner.

Name of Participant *

First

Last

NDIS Number *

Date of Birth *//

Nominee Name

Phone *

Email *

Address of Participant *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

My NDIS plan is managed by *

Plan Management
Self-Managed
Agency Managed

I would like payment for this order to be taken from *

Assistive Technology
Core Supports / Daily Activities
Improved Daily Living

Terms and Conditions *

I agree to allow NADO to process a claim for Products as per my order

This form constitutes a Service Agreement between the participant and NADO. We confirm your order in 48 hours.

Once this form has been submitted, you will be redirected back to the CHECK OUT page to complete your order. We will be in touch with you in 48 hours.

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