Consent for the NDIA to share your information

Please complete and sign this form to give the National Disability Insurance Agency (NDIA) permission to share your information on your behalf. The information we will share will depend on the permission you give us on this form. For example, you can agree to us sharing information to a third party about:

  • you
  • your plan or your funded supports
  • your medical reports held by us
  • your NDIS plan being developed
  • requests asking us to review a planning decision we have made.

You do not have to give your permission if you do not want to share your information. If you give us permission and then decide that you don’t want us to share your information anymore, you can withdraw your consent by contacting us. You can do this in writing or verbally. We will not share your personal information to anyone unless you have given your permission or the disclosure of your information is required or authorised by law.
Note: You can provide your consent to share your information with up to three people and/or
organisations on this form.

How do I return this form to the NDIA?

  • Email:
  • Mail: NDIA, GPO Box 700, Canberra ACT 2601
  • In person: Visit a Local Area Coordinator, Early Childhood Partner or NDIS Office in your area

Privacy and your personal information

Collection of your personal information

The National Disability Insurance Agency (NDIA) would like some personal information from you to simplify your engagement with the NDIS. Any personal information you provide to the NDIA is safe under the National Disability Insurance Scheme Act 2013 and the Privacy Act 1988. You can also ask to see what personal information (if any) we hold about you at any time and can seek correction if the information is wrong.

Personal information use and disclosure

The NDIA will use your information to support your involvement in the NDIS.
The NDIA will NOT use any of your personal information for any other purpose, or disclose your personal information to any other organisations or individuals (including any overseas recipients), unless authorised by law or you provide your consent for us to do so.

The NDIA’s privacy policy describes

  • how we use your personal information.
  • why some personal information may be given to other organisations from time to time.
  • how you can access the personal information we have about you on our system.
  • how you can complain about a privacy breach, and how the NDIA deals with the complaint.
  • how you can get your personal information corrected if it is wrong.

You can find the policy at the NDIS website (

Personal information storage

The NDIA uses an Australian Government computer system to store personal information. System users, other than NDIA staff, may at times be able to see your name when they perform program duties, however they can’t record, use or disclose information, and they will not know if you become an NDIS participant. State or territory government officials may also have personal information access as part of the agreement between governments to assist the states and territories in their NDIS evaluation.