Online Reimbursement Form

By completing the following form and sending it to us, you are asking Blitzit Plan Manager to request a reimbursement from the NDIS based on a payment that has already been made to a service provider.

Participant Details

This is the person receiving the NDIS funding

Parent, Guardian or Authorised Representative Details

If required

Participant I am the Participant, and I am completing this form on my own behalf.
Parent I am the parent of the Participant who is under 18 years of age.
Guardian I am the guardian of the Participant and I am authorised to make decisions on their behalf.
Authorised Representative I am the Authorised Representative of the Participant and I am authorised to make decisions on their behalf.
Bank Account Details

Please provide the bank details of the person receiving the reimbursement

Invoice Details To Be Reimbursed

Please ensure the Original Tax Invoice and proof of payment has been attached


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Blitzit Plan Manager will process and pay reimbursements which meet the reasonable and necessary criteria, and is within the allocated budget in accordance with the National Disability Insurance Scheme Act 2013.