Phoenix App

My Account

*Photo Tips: Submit one color photo. Use a clear image of your face. Do not use filters commonly used on social media.

Personal Details

Your personal information is private, and will not be publicly displayed, except for your ‘Preferred Name*’, and ‘Profile Picture’.

*If you don’t have a preferred name, your first name will be shown in your profile instead.

First Name *

Middle Name

Last Name *

Preferred Name

Date of Birth *

Email *

Mobile *

Verify

Security

Current Password *

Show

New Password *

Show

Verify Password *

Show

Two Factor Authentication (2FA)

ON OFF

Emergency Contacts

Name

Ethan Johnson

ethan@gmail.com

Mobile

+64 21 3993 0390

Edit

Edit Delete

Name

Ethan Johnson

ethan@gmail.com

Mobile

+64 21 3993 0390

Edit

Edit Delete

Name

Ethan Johnson

ethan@gmail.com

Mobile

+64 21 3993 0390

Edit

Edit Delete

Who would you like to organise care for?

Myself

Loved one

Whats your gender? *

Male

Female

Others

Postal Address *

Payment Details

File Manager

Upload Required Files

Please upload the following required documents: Direct Payment Authorisation.

You can download the ‘Direct Payments Authorisation’ form here.

Direct Payment Authorisation *

File name without special characters. Accepted file formats: PDF. Max file size: 10 MB

Terms & Conditions

*Photo Tips: Submit one color photo. Use a clear image of your face. Do not use filters commonly used on social media.

Male

Female

Others

Credit Card

Manual Deposit

Claim Funding

If you wish to pay by Manual Deposit, please deposit on our Mycare Bank Account:

### ### ### ##

And in your statement details, please add in Particular your Last Name and First Name.

If you wish Mycare to claim funding on your behalf to your Individualised Funding (IF) host please provide the following

Host *

Disability *

Select one or more options from the list below:

Physical
Intellectual
Sensory
Development Delay
Autistic
Neurological

Direct_Payment_Authorisation.pdf

Tuesday 27/11/2023 at 2:01pm by Jackson

My Account

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