(07)3448 0052

Interested in Mental Health First Aid Training? Click here to learn more and view our training dates.

Customer Enquiry

(07) 3448 0052

apply for a service

Apply For an NDIS Service


Thank you for choosing CiMaS for helping you manage your NDIS plan. This page contains our client application for our NDIS service. All information collected in completely confidential and collected only for the purposes of managing your package. 

By submitting this form, you are engaging in a commitment to CiMaS for this package. Upon receiving your application, CiMaS will follow up with you regarding any additional information or payment details we may require. 

NDIS Application

What is your preferred method of contact?

Do you identify as Aboriginal or Torres Strait Islander?

Power of Attorney

Who is authorized to sign documentation?

Do you have an NDIS plan?

NDIS Plan Funded By:

NDIS Plan Managed By:

Please select which of our services you would like to request.

Please select which type(s) of Continence Assessment you would like to request

Do you suffer from any of the following conditions?

Do you have any other service providers involved?

Do you consume alcohol?

Do you smoke cigarettes / e-cigarettes?

How would you like to follow up on your application?

Client Acceptance and Commitment

Our Office

3 Hamilton St Booval 4304

Contact Details

Call: 3448 0052
E: admin@cimas.net.au
F: (07) 3112 4236