Lilly’s Little Lunchbox: NDIS Agency-Managed Meal Service Enquiry Form

We are a proud registered NDIS provider offering healthy, ready-made meals for delivery to support participants of all ages.

If your plan is agency-managed (managed by the NDIA), please complete this form. We will handle billing directly with the NDIA.

Participant Details

Parent/Guardian/Carer (If Applicable)

Delivery Details

Meal Plan Preferences

NDIA Contact Details

Authorisation & Declaration

By submitting this form, I authorise Lilly’s Little Lunchbox to:

Provide meals as outlined and invoice the NDIA directly.

Contact me or my NDIA representative for any clarifications.

Proceed with service under the NDIS item code 01_023_0120_1_1 – Assistance with the Preparation and Delivery of Meals.

I understand that I am responsible for ensuring the availability of sufficient NDIS funds. If funding is not approved or available, I agree to cover the cost of meals delivered.