Full name * Email address * Telephone number * NDIS participant number Date of birth * Residential address * Regular Pickup address (If Different to residential) Regular Drop off address (If Applicable) Which category describes you best? * NDIS participantGaurdian/FamilySupport Co-ordinatorAgency Support Co-ordinator or Agency name: (If Applicable) How is your NDIS managed?* Self ManagedPlan ManagedAgency Managed What is your preferred method of contact? * EmailTelephone Do you receive Taxi User Subsidy Scheme (TUSS)? * YesNo If yes, what category of TUSS do you receive? 50%75%None of Above What are your vehicle requirements? * Up to 4 passengersUp to 6 passengersUp to 12 passengers Do you require wheelchair access? * YesNo Does a Carer or family member travel with you? * YesNo How did you hear about Ability Transit Solutions? NDIS My PortalInternet SearchFriend or FamilyExpoATS ReperesentativeATS WebsiteOther Any additional information that you would like to share with us?
