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ADIEM

Service Agreement


If you would like ADIEM to manage your NDIS plan and pay providers on your behalf, please fill out the following form and submit. On submission, a pre-populated service agreement will be sent to your email address for you to review. When you receive the email, you will see that the form has extra fields where you can provide extra information such as bank details and automatically approved providers for easy payment.

All fields marked with an asterix * must be filled in.

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NDIS Plan Details (Required)



Participant's Details (Required)





Service Agreement Details

Enter the details for who will be signing the service agreement, their relationship to the participant if they are not the participant and the email address for the delivery of the service agreement.