Online Booking Request For NDIS Cleaning

If you have any questions or would like to discuss your service over the phone, please call us on 1800 450 453.

Book Your NDIS Cleaning Service

Complete the form below to make your booking request.

NDIS Participant Name*
Please ensure this is the full name (not shortened nicknames) that we can use for the Service Agreement.
First Last
NDIS Number*
This usually starts with '43
Participant Date of Birth*
DD/MM/YYYY
Representative Name (if applicable)
First Last
Email*
Email address of the primary contact for this service.
Phone*
Phone number of the primary contact for this service.
Address of the Property to be Serviced
Please let us know the exact address of the property so we can check availability for your cleaning service.
Street Address*
Suburb*
State/Territory*
Postcode*
Details of your NDIS Plan
Please let us know the details of your personalised NDIS Plan.
Name of your Plan Manager (if applicable)
Start Date of NDIS Plan*
DD slash MM slash YYYY
End Date of NDIS Plan*
DD slash MM slash YYYY
Do you want your agreement to end before your NDIS plan?*
- (Recommended) No, I want it to run as long as my plan is active.
- Yes, I would like my service agreement to end early.
I would like my agreement to end on:
This can only be before or on the date of expiry for your NDIS plan.
DD slash MM slash YYYY
How do you pay your NDIS Providers?*
What is the best email address for invoices to be sent to?*
(If you have a plan manager please enter their email, if you are NDIA or self-managed please enter your own email.)
Has a Maid2Match Team Member assisted you in completing this form? If so, please put their name below.
NDIS Services You Are Requesting
Please provide details about the property that is being serviced.
How many hours would you like to have a cleaner for?*
How often would you like to have a cleaner?*
What are your preferred day/s and time/s for your service?*
Please note that we do not currently provide services on weekends.
What is your preferred method of communication about your cleaning service?*
We try to stick with your preferences unless the situation is urgent.
- Email
- Phone call
- SMS
What is your preferred time of day for communication about your cleaning service?*
We try to stick with your preferences unless the situation is urgent.
- AM
- PM
Please give some thought to providing us with any specific details you would like us to know about your participant. This helps us provide the best house cleaning experience possible.*
Do you have any gender preference for your cleaner? Will there be any pets at the property? Is there anything else you would like us to know that might be helpful?
How did you hear about us?*
Who are you?*
If other, please specify:

What happens next?

We will be in contact within 24 hours to arrange for you to review a draft Service Agreement. Should you have any questions please email: [email protected]

Online Booking Request For NDIS Cleaning

Book Your NDIS Cleaning Service

Address of the Property to be Serviced

Details of your NDIS Plan

NDIS Services You Are Requesting

What happens next?

Services

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