The ACFB Fund

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ACFB Release of Information Form

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Client's Name
Parent/Guardian Name (if applicable)
Date of Birth
Description of what you are happy with having released to this recipient - normally this will just be your assessment report but you can specify here any of the psychometric results, any completed forms etc.
Some information about why you want your information to be able to be released to this recipient.
Effective From Date
Authorisation Expiration Date
If you want this to expire prior to 1 year from the date of signing.
Recipient's Name
GP, Counsellor, etc.
Complete this if known / relevant
Release of Information Consent
1. YOUR AGREEMENT

By agreeing to this release form, I understand that my information will be held in accordance with the NZ Privacy Act 2020. That this authorisation is voluntary and may be revoked at anytime by providing notice to admin via email. I understand that I will need to sign a new consent form each year or my nominated person will lose access. I will be informed about what information specifically will be given, it's purpose, and who will receive the information. I understand I have a right to a copy of this release form should I request it.
Clear Signature
Name of Signatory
If you are signing this on behalf of the client (ie. if you are their parent or guardian) then please fill in this field

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About Us

A Change For Better (ACFB) is a web-based platform for members of the public and mental health professionals alike. ACFB is a safe place to learn, interact, and gain support. 

Recognizing that significant change can take time, ACFB provides members with tools and support to achieve sustainable change in their lives.

The ACFB Fund was born out of the idea that with power of community, we can create a self-sustainable means for those who need mental health support and psychological assessments. Funded by ACFB and private donations and assessment fees, the ACFB Fund hopes to grow to help as many Kiwis as possible.

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Charity Details

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A Change For Better – The ACFB Fund is a registered charity with Charities Services NZ

Charity Number: CC61221

If you are looking for autism related funding through NASC/ Whaikaha then this is not the assessment for you at this time.

Whaikaha have changed their minds after years of accepting telehealth diagnoses and have said our diagnoses no longer meet their long list of strict criteria. We will be providing support to those who already received a diagnosis with us but are not sure about going forward if we will continue the higher requirements now set forth by Whaikaha. 

In the meantime, we are advocating to anyone and everyone who might be able to help us and would love your support as well. Please make a complaint. You can find more information on the Whaikaha website here.

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The ACFB Fund is not a crisis counselling centre, and we cannot provide emergency services for active or prospective clients.

If you’re in a life-threatening situation or experiencing a mental health emergency, this service is not appropriate for you at this time. Instead, use the following helplines to get the support you need:

  • Lifeline New Zealand: 0800 543 354 (call or text)
  • Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO)
  • 1737 – Need to Talk?: Free call or text 1737 to speak with a trained counsellor (available 24/7)
  • Healthline: 0800 611 116 (available 24/7)

These contacts are available for immediate crisis support and can help connect you to further assistance.

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Thank You

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Thank you for submitting your application to The ACFB Fund.

Our team will review your application and be in touch with you soon.

To access some of our free resources then please take a look at our Wellness Info