Meal Prep & Delivery Claim

Plan Mana gement Reimbursement

and Reasonable & Necessary Form

PARTICIPANT DETAILS

Participant’s Full Name *

NDIS Number

Date of Birth *

Email *

Reimbursement Details

Name of Business or Provider

Invoice or order number

Cost of meals

Delivery Cost

Claim AmountTotal claim = 70% of meals + 100% of delivery

Attach a copy of the invoice or order confirmation here:

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Authorisation and Acknowledgement

By signing and submitting this document, I confirm that:

Meal preparation support has been funded in may plan.

I am aware that during an audit process, NDIS may disagree with my decision to use my funding for this support and may require me to refund the cost of this purchase.

I accept full responsibility should I be required to refund any amount to the NDIA, and will work with Boon Consulting to ensure that any debt raised is resolved as quickly as possible.

I will not hold Boon Consulting financially liable for any decision I have made on how to spend the funds in my NDIS Plan.

Participant/Representative Signature *

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Participant/Representative Name *

Date *

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