This form is for organisations to assist individuals apply for a Hāpai Access Card by validating the barriers they face in the community. 


The card is available to people who have a physical or mental impairment, and where that impairment has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. 


As part of an organisation you will be validating which of the nine barriers that an individual faces.  Please ensure you have enough information about the individual to be able to make this assessment. 


An authorising manager will receive an email after you have submitted the form to formally confirm that the barriers ticked are correct.


More information around the nine barriers can be found at www.hapaifoundation.org.nz/barriers. Please make sure the barriers you are tick are relevant for this person. 


The name, username and photo associated with your Google account will be recorded when you upload files and submit this form.
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