KISA phone is the ultimate simple phone!

Step 1 of 5:Front of your KISA NDIS Emergency device

Please enter names and phone numbers for your contacts. You can have up to 10 contacts. Phone numbers are optional and can be changed remotely later.

Name

Phone Number

Same size text on all buttons

Braille contact buttons on the front of the phone.

Step 2 of 5:Back of your KISA NDIS Emergency device
Please enter addition information to be shown on the back of your KISA NDIS Emergency Device.

NDIS participant name: My address: Medical conditions: Emergency contact:

Show assigned phone number on the back of KISA NDIS emergency device.
Phone number details:

I want a new mobile number
I want to keep my existing mobile number

If you want to get a new mobile number with KISA, we will assign that number to you. The number cannot be changed once assigned and you will not be able to transfer a different number to KISA once you have placed your order.

You can transfer an existing mobile number to KISA, but you need to be aware that you will need to terminate your contract with your existing provider and this may have consequences for you (including payment obligations to your existing provider). See our FAQs for more details.

Please enter the phone number associated with your SIM card.

Mobile Phone Number:

Please note: if you don't provide us with your mobile number, you won't have access to remote control settings and be able to make changes to the phone, because we require the mobile number to be able to send an update to the phone.

If you do not know what the mobile number is now, please leave it blank and submit the order and then contact our friendly team on: 1300 557 453 to provide us with what the mobile number is so that we can update our records.

This is a billed service
This is a prepaid service

Current Mobile Provider:

Provider:

Service Account Number:

SIM Card Account Holder DOB:

Acknowledgment of obligations:
I declare that I have a contractual right to the Mobile Service Number(s) (“MSN”) and am authorised to request porting of the MSN. I acknowledge that Kisa has advised me that this Customer Authorisation Form is only valid for a period of 30 days; and that porting will take place within 2 business days of the date nominated on this form is submitted. I acknowledge that I have been advised that by Porting the Mobile Service Number, the service and/or Related Services associated with that Number may be disconnected from the Losing Service Provider and may result in finalisation of the account for that service. I authorise the MSN and the Network Type (GSM, UMTS) and any other porting information to be disclosed to other carriers, network providers, portability service suppliers and financial institutions for the purpose of porting and routing of calls to the MSN, complaint handling, customer and network fault management, fraud prevention and fraud investigation.
I acknowledge that I have been advised by Kisa that I must use a KISA phone handset with this service and my old handset cannot be used.
I acknowledge that I have been advised by Kisa of the following:

Although I may have the right to Port the Mobile Service Number, there may be costs and obligations associated with the existing mobile service and Porting the Mobile Service Number;

I may or may not be in an existing contract with the current Service Provider; and

The contract may or may not include an obligation to make early termination payments to the current Service Provider.

Tick All
Step 3 of 5:KISA NDIS Emergency device Design

Choose from one of our designs:
Step 4 of 5:NDIS Participant Details

Step 5 of 5:KISA NDIS Account Details

We recommend for the Account Holder to be a carer or a family member, not an NDIS participant.

You are adding a new phone to your existing account.

You do not need to re-enter your registration details.

Title:

First Name *:

Last Name *:

Email *:

Confirm email *:

Primary Phone Number *:

Alternative Phone Number:

DOB *:

Primary / billing address:

Address Line 1 *:

Address Line 2:

Suburb *:

Post Code *:

State *:

Country:

Tick this to ship to a different address

Shipping address:

Title:

First Name *:

Last Name *:

Email *:

Mobile Phone Number *:

Address Line 1 *:

Address Line 2:

Suburb *:

Post Code *:

State *:

Country:

Please tell us how you found out about KISA:

KISA NDIS Package Includes:

KISA NDIS Emergency Device
KISA NDIS Emergency Device Accessories
12 Months KISA NDIS GPS Tracking Service
12 Months KISA NDIS Unlimited Service
Postage & Handling
Total:

To proceed, please click on the Submit Order button below.
Our KISA Team will be in touch with you if we require any further information.
Your KISA NDIS Emergency Device will be manufactured and sent to you after payment has been received.

If you have any additional information about this order, please provide it below:

I agree to terms and conditions *

Submit KISA NDIS Order

Acknowledgment of obligations:

KISA NDIS Package Includes: