Honourable Support

Participant intake form

Tell us what help you want. The form stays short for ordinary support and opens extra questions only when they are relevant.

Most simple-support forms take about 5 to 8 minutes. Help around the home, shopping, appointments or getting out should not require complex-care questions. If this is your first contact, you can still use the short participant enquiry instead.
You can complete this form yourself, ask someone you trust to help you, or complete it together with Honourable Support. If you are answering for someone else, answer from their point of view where possible. Only include information that is relevant to the support they want from us.

Before you begin

Complete it your way

You can fill this out in your own time, or someone can help you work through each section.

Only share what is relevant

Health, behaviour and personal information only need to be included when they affect your support or worker safety.

The form adapts to you: Simple support follows the shorter pathway. Personal care, medication, mobility or other important safety needs open the additional planning questions in this same form.
Your answers save automatically on this device. To continue on another phone or computer, choose “Save and continue on another device”. If you are using a shared or public device, finish and send the form in one sitting, then open “More options” and clear the saved answers.
Section 1

Who are we supporting?

Tell us who needs support and how we can contact you.

Enter the participant’s first and family name exactly as shown on their NDIS record. A first name by itself cannot be submitted.
Add the participant’s email, or add a representative’s email below. One email is needed before the full form can be sent. After submitting, please check your Inbox, Spam or Junk folder for our response.
Best time to contact you
Add an exact day or time
Communication or accessibility needs
Add another communication need
Add a family member, nominee or other contact

Complete this only if you would like another person involved in decisions or contact.

Use this if the representative should be the main email contact. After submitting, please check your Inbox, Spam or Junk folder for our response.
Section 2

Who pays for your support?

Tell us how your support will be paid for. Choose the help you want in the next section.

Your NDIS plan

A plan manager pays invoices for you. If you are unsure, we can help you check.

These dates are on your NDIS plan. You can save your answers and come back if you need to find them.

Where do we send invoices?

Optional: add a contact person or payment note
Optional: add a budget or other payment details

You can leave these blank. We will check the budget and any support item numbers with you before support starts.

Optional: add your support coordinator

Add this only if you want us to contact your support coordinator about your support.

Section 3

What would you like help with?

Start with the ordinary support you want. Open the additional-support choices only if they apply.

Common supportChoose everything that applies.
Personal care, medication, mobility or another support
Does a worker need special health, personal-care, behaviour or safety instructions?This answer decides whether the shorter form is enough. Personal care, medication or mobility support will always open the additional planning questions.
1
Choose the support and planning answer above.We will then show only the sections that fit.
What would you like support to help with?
Add something not covered by the choices
Optional: add boundaries or things a worker should not do
Things a worker should not do
Section 4

When and where is support needed?

Choose the days and times that work for you. We will check worker availability with you.

Your support times

Choose any days, including weekends. Each time slot can be 2 to 24 hours. Set a start time and hours, or choose the finish time. Add another time to split a day.

Can the support time move if needed?
Add another acceptable time
Please do not include alarm, key-safe or entry codes here. We will collect those securely later if needed.
Optional: add who is present or how roster changes should be communicated
Who is normally present during support?
Add somebody else
How should shift confirmations or changes be communicated?
Add another roster instruction
Section 5

What makes a good support relationship?

This is where we understand you as a whole human being, not just the service you need. It helps us find a worker you can genuinely feel comfortable with.

Mostly clicking from here.Choose every answer that sounds right. Open an “add something else” box only when the choices do not cover it.

Which words sound most like you?Choose as many as you like. This helps us connect you with a support worker who suits you.
Add something else about yourself
What are you interested in?These choices help us suggest workers who may share genuine interests.
Show more interests
Add an interest that is not listed
What might you enjoy doing with a support worker?
Add another activity or conversation topic
What helps make support feel like a good day?
Add something else that helps
What can make support difficult?
Add another thing that can make support difficult
What sort of worker might suit you?
Add another personality preference
Are any of these worker preferences important?Choose only genuine comfort, communication or support needs. Honourable Support makes the final match fairly using relevant information.
Add the specific language, cultural or other preference
What experience or skills would help?
Add another skill or anything that would make a worker unsuitable
How would you like to meet a possible worker?
Add a question or meet-and-greet request
You can tell us when a worker does not feel like the right fit. A worker can say the same. Our job is to find an arrangement that works for both people.
Additional planning

How should workers provide the support?

This section appears only when the selected support needs more detailed communication, routine, personal or safety instructions.

Tap the instructions that fit.You can still add exact personal instructions underneath when they are needed.

How should a worker communicate with you?
Add specific communication instructions
How much help feels right?
Add more about independence or help
Which everyday approaches are important?
Add a routine, privacy or household boundary
Will a worker help with shopping, money or property?
Add agreed limits or instructions
Selected support

A few details about the help you want

Only the services selected earlier appear. Ordinary support stays click-first and short.

Cleaning and household tasks

Which tasks are needed?
Products and equipment
Add cleaning details, priorities or safety information

Personal care

Which personal care tasks are requested?
How should the worker help?
Important privacy preferences
Add exact personal care instructions

Meals, eating and drinking

Which meal tasks are needed?
Food needs
Add food preferences or exact safety instructions

Transport and community access

Usual destinations
Vehicle or access needs
Travel costs
Add a destination, vehicle detail or cost arrangement

Medication support

Medication support requires a further check. We will need current written instructions and a suitably trained worker before medication administration can be arranged.

Mobility, transfers and manual handling

Mobility equipment used
Transfers or physical assistance requested
Add other equipment or transfer details

Social and community support

What would you like support to attend?
What approach helps in the community?
Activity costs
Add a place, boundary or cost arrangement

Daily living support

Which daily living tasks or skills?
Preferred prompting style
Add a task or prompting instruction

Other requested support

No specialised service section is currently selected. You can continue, or return to Requested Services to change the selections.
Safety check

What does a worker need to know to keep your support safe?

This is not a full medical history. Simple support only needs a quick safety check and emergency contact. Extra questions appear when an instruction or plan is relevant.

Choose only what affects support or safety.Open an instruction box when a worker needs an exact response, contact or participant-specific method.

Is there anything about your health or safety the worker needs to know?
Signs a worker might notice
Helpful first responses
Home or worker safety
Would missing a shift create a serious risk?
Add exact health, behaviour or safety instructions

Emergency contacts

Do you have any written instructions to share?

Completion

Check your answers

Check your answers, correct anything missing and send the form privately to Honourable Support.

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