Participant - Cancel A Service

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Phone

1300 611 515

Email

admin@buddyhub.org

Who is Cancelling a Service?

What is their Phone Number:

Is this request to Cancel ALL Supports provided by BuddyHub

What type of Supports are being requested: (Select all applicable) * Required

Cleaning

Transport

Community Access

Daily Living Assistance

Support Coordination

Plan Management

Home Modification

Independent Living (SIL)

Accommodation

Other

Date the Service was to be provided:: * required

Location for the Supports:

Reason for cancelling the Supports in your own words (OPTIONAL):

You confirm that you are the Participant, Representative, Nominee or other party with authority to Cancel the above AND you acknowledge the BuddyHub Cancellation Policy may apply to Short Notice / No Show and other cancellations found at this

link

Your Service Cancellation has been submitted. A BuddyHub Representative will be in touch soon.

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