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We welcome your interest in being part of Autism NZ Early Years Pathway which commences in early October.

This new Autism NZ service is funded by the Social Investment Agency (SIA) over a 4-year period to develop and deliver an integrated pathway of support for tamariki aged 18 months to 6 years through to the end of the first year of school.

The program is open to children who:
  • are currently aged 18 months to 4.5 years and:
  • have an autism diagnosis or show early signs of autism.

During this 4-year funding period we aim to work with 200 families at different stages of the early pathway.
Information about your child and whanāu

We would like to gather some initial information about your child and would like you to complete the information below.

If you would like some assistance in completing this form, please contact the Early Years Pathway Lead by emailing phoebe.jordan@autismnz.org.nz

If you are working with another provider, they may be able to support you to complete this form, or they can complete it on your behalf with your consent.

By completing this form, you hereby consent to Autism New Zealand collecting your data.

Privacy Information:
  • Autism New Zealand collects personal information. This is kept confidentially and used only with whanau consent to help plan and inform a pathway that is individualized for your tamariki and whanau.
  • Information requested and held is for the purpose of providing our services. It may also be used for statistical purposes in a way that does not identify the individual.
  • The information collected will be held securely in our client database and information will remain confidential and available to the Autism New Zealand early years pathway team only for at least 10 years.
  • Providing information is optional, however not providing some details may impact timeliness and how we can support you.
  • You have the right to ask for a copy of any of the personal information and to ask for it to be corrected if you think it is wrong.
We will be in contact with you within two weeks of recieving this registration of interest to organize a meeting to discuss next steps.

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* Are you completing this form as the primary caregiver, or on behalf of a family/whānau?

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* By completing this Registration of Interest form I agree that the information I have provided may be used for statistical and research purposes in a way that does not identify me, my child/tamaiti, or my whānau.

If you are filling this out on behalf of a child/whānau, you agree that the family has been informed and agrees to the information being used for these purposes

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