Early Steps: Early Intervention Service Request Form EarlySteps is an Autism New Zealand early support service approved and funded by the Ministry of Education. It provides the earliest possible help to support autistic tamariki & their whānau We pride ourselves on being the first Ministry of Education funded provider in New Zealand of an autism specific early support service and look forward to making a positive difference.We work with whānau (families) and kaiako (teachers) involved with the tamariki. While a diagnosis of autism is preferable, where there are queries about tamariki showing signs of autism are also accepted into the service. Through this service we also support the Tamariki transition into school from home and ECE.By completing this form, you hereby consent to Autism New Zealand collecting your data.Privacy Information: Autism New Zealand collects personal information. Information requested and held is for the purposes of providing our services. It may also be used for statistical purposes in a way that doesn’t 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 team only for at least 10 years. We will only collect health information directly from you or your child, or where you expressly authorise collecting from another source (e.g., incoming information from your GP or another health provider making a referral to us). We will only share health information where you expressly authorise that sharing (e.g., outgoing information shared with your GP or another health provider). We may also share information with other health providers when we have genuine concerns as to you or your child’s health, safety or wellbeing. Providing information is optional however not providing some details may impact the services that we can offer 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. Question Title * Are you based in West Auckland? Yes No Next