Registration :: inhousing

NDIS Registration Status

Are you registered with the National Disability Insurance Scheme?* Yes No Unsure

Your personal details

What is your email address?*

We'll use this to manage your registration and keep you up to date with appointments and news.

What is your first name?*

Your first or christian name as it appears on your birth certificate or medical records.

What is your surname?*

Your family or surname as it appears on your birth certificate or medical records.

What is the street address of your current home?*

What city is this home in?

What state is this home in?

What is the post code?

What is your phone number?*

What is the best number we can contact you on ?

What is your gender?* Male Female

What is your date of birth?* (DD/MM/YYYY)

What is the nature of disability you or a household member lives with?

Choose all that apply

Physical Intellectual Psychosocial Hearing impaired Sight impaired Other (describe) None

Income Details

Accessibility Design Features

What best describes the accessibility design features you need in a home?* High Physical Support - designed to a high level of physical access for people living with significant physical impairment, e.g. uses an electronic wheelchair Fully Accessible - designed to a high level of physical access for people living with significant physical impairment, e.g. uses a manual wheelchair Enhanced access - minor mobility improvements, e.g. a person who is ambulant but may require walking aids Standard Access - but I need specific property features for my sensory or cognitive needs None - no specialised design features required

Source and Level of Support with daily living

Do you receive support with your daily living?* No Freely given by my family or friends A person is paid a Carer's Allowance to live with me and care for me A Personal Support Agency worker Unsure

Do you have a public or community housing rental application lodged?*

Have you completed a registration of interest form with Housing SA or with a Community Housing provider?* Yes No Unsure

Guardian or someone acting as Power of Attorney

Is there someone that assists you with your affairs (Guardian/ or someone acting as Power of Attorney)?* Yes No Unknown

What type of property would you like?

Where do you need to live, how many rooms do you need and what features will help you?

Choose all that apply

Attached House Detached House Apartment Villa, generally in a small cluster Unit, shared yard and/or parking

How many bedrooms are needed?* One Two Three Four

Is a yard and garden area needed?* Yes No

In which general areas is a property required?*

Choose all that apply

North Metro Adelaide Outer North Metro Adelaide South Metro Adelaide Outer South Metro Adelaide East Metro Adelaide West Metro Adelaide Other Regional Area

Does the property need room for your support provider?* To stay overnight To work during the day No

Other House Members

Are there other people who will live with you?* Yes No

Housing Registration

Registration Form

Personal Details

Income and Support

Housing Requirements

Other House Members