Whānau Hygiene Pack Survey

Tēnā koe,

Te Whānau o Waipareira through the Whānau Ora Commissioning Agency is providing hygiene packs to whānau in our community which includes soaps, tissues, gloves and cleaning products to help our whānau keep safe and well during the pandemic

We would like to hear from you if your household is yet to receive a COVID-19 Hygiene Pack from anyone in the last few weeks.

If you would like to receive a hygiene pack for your whānau, please fill in the quick questionnaire below and select the submit button

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* 1. Choose the high need below that you have in your household.

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* 2. Does your household identify as being Māori?

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* 3. Which of the ethnicities below best describes those in your household?

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* 4. Main whānau contact name:

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* 5. Main whānau contact mobile number:

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* 6. Street Address:

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* 7. Suburb:

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* 8. Post Code:

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* 9. Number of 0-12 year olds in your household?

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* 10. Number of 13-24 year olds in your household?

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* 11. Number of 65+ year olds in your household?

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* 12. Preference for delivery of Hygiene pack

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* 13. Is there other support you require ?
If you are seeking further support and would like to talk to us, please contact us on : 0800 924 942

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