Match/Information Requests



If you want to make contact with another parent whose child has similar needs, and/or if you want more information on your childs disability or health impairment, our National Office (where our extensive data files and library are kept) will be contacted when you submit this form.
The service is both free and confidential to families.
Organisations are also able to access information on the 3600 different conditions covered and can do so by going to the on-line request form

Please note - when filling in the form, use the TAB BUTTON or your MOUSE to go to the next field.

Please do not use the ENTER key

Name
Address
Country
Telephone
Email
Ethnicity
(required for statistical purposes only)
NZ European or Pakeha
NZ Maori
European
Samoan
Cook Island Maori
Tongan
Niuean
Chinese
Indian
Other, please state
Childs Name
Childs Age
Childs Gender
Childs Disability/Health Impairment/Special Need
Requesting
Contact with another family
Information on a condition
Other
How does the condition/s affect your child
If other than above, please specify