Provider registration form
Provider Registration Form
Complete and sign your NDIS provider registration agreement
Verify your email
We'll send a 6-digit code to confirm you control this address before you can submit.
Organisation details
Provide the information required for NDIA provider onboarding.
Organisation
NDIA provider
PRODA/RAM administrator
The PRODA/RAM Administrator is the person in your organisation who has administrative access and permissions to manage your PRODA or RAM devices. This individual must have the B2B device attributes assigned to them in order to successfully complete the B2B device registration process with the NDIA.
Management representative
The Management Representative is the person who has the authority to sign this onboarding application on behalf of the entire organisation. This is usually a senior leader such as a Director, CEO, General Manager, or Owner.
IT team contact
The IT Team Contact is the technical person responsible for connecting your platform to our systems. This individual must have administrative access to the software/platform being used in order to complete the integration and B2B device registration.
Other
Sign & submit
Confirm authority details and sign to complete your onboarding submission.
Authority
Sign here
Submission received
Thank you. Your onboarding form and signed document have been submitted successfully. Our team will be in touch if anything further is required.