Leap in! Plan Management Registration

Established in 1982, Alzheimer’s WA provides direct care, support, education and information to assist people living with dementia as well as their families and carers.

As the dementia experts, Alzheimer’s WA works with those living with dementia and the organisations that care and support them, to have the greatest beneficial impact on their dementia journey.

When you’re looking for a plan management provider, we recommend the services of Leap in!, a not-for-profit, specialist plan manager who shares our values around delivering premium NDIS services that assist people with a disability to achieve positive outcomes and live their best life.

How to register with Leap in!

Enter your details in the form below and upload a copy of your NDIS plan.
Read and agree to the Leap in! terms.
Click on the “Send” button.

Participant Details
Please Note: All details must match those listed on the participants NDIS plan.
Participant First Name*
Participant Last Name*
Participant Date of Birth
Date Format: DD slash MM slash YYYY
Street Address
Suburb
State
Postcode
NDIA Participant Number
NDIA Plan Start Date
Date Format: DD slash MM slash YYYY
NDIA Plan End Date
Date Format: DD slash MM slash YYYY
Improved Life Choices/CB Choice Control
(Amount listed on NDIS Plan or Portal) - this is your Plan Management budget.
Please attach a copy of your Plan
(or alternately, we will request this from you at a later stage)
Accepted file types: jpg, gif, png, pdf, doc, docx.
Nominee/Participant Contact Details
Nominee First Name (If this is your NDIS plan, simply write your name)*
Nominee Last Name (If this is your NDIS plan, simply write your name)*
Email Address
Contact Mobile*
Relationship to Participant
How did you hear about Leap in!?
Agreement*
- I agree the details I have provided are correct.
- I have read and agree to Leap in! Plan Management Terms.
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Comments
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