The ACFB Fund

The ACFB Fund Logo
Search
Close this search box.

ADHD or Autism Application

Please read this application carefully and respond to all of the required questions (marked with a *)

Please enable JavaScript in your browser to complete this form.
What support are you looking for?
Please provide the name of the indivudal who needs the assessment(s)
Gender
Please let us know the gender of the individual who needs the assessment(s)
Please provide the name of the parent, guardian or support worker if this is an application being created on behalf of someone else. This can be left blank if you are submitting this application for yourself.
Location
Ethnicity
If this application is for a child (younger than 18) who is still living at home then please make this the household income.

For adult couples (18 or older) this is your household regular income from any source - salary, wages, WINZ, student allowance etc

For any other single adult (18 or older) this id your regular income from any source - salary, wages, WINZ, student allowance etc
Do you have a history of bi-polar or trauma
Click or drag files to this area to upload. You can upload up to 5 files.
You can do this as up to 5 images if you need. Please make sure it is your most recent statement. We are using this to validate your regular income

File Types accepted: jpg,gif,pdf,heic,png,webp,jpeg
Click or drag files to this area to upload. You can upload up to 2 files.
You can do this as up to 2 images if you need.

File Types accepted: jpg,gif,pdf,heic,png,webp,jpeg
Click or drag files to this area to upload. You can upload up to 3 files.
You can do this as up to 3 images if you need.
File Types accepted: jpg,gif,pdf,heic,png,webp,jpeg
In submitting this application I understand/agree with the following :

* That my information and application will be viewed within the ACFB Fund Clinical Team to determine my eligibility.
* I have provided documentation of ALL income sources and understand that if I am dishonest about my true income, I may not be accepted into the program.
* I consent to my information being viewed for the purposes of auditing my application.
* I also understand that The ACFB Fund will keep confidential records on the statistics around how my application/funding is used and may reach out for this purpose.
* If accepted into the program, I agree to participate in collecting feedback on the program with the aim of gaining additional funding.

If you are unsure about any of these, please email info@acfbfund.org.nz with your questions before submitting this application
Agreement

Thanks to our Sponsors!

Google
HawkesBayFoundation
TFlogo_RGB_Leftalign_navy

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.

Quick Links

Menu

Charity Details

The ACFB Fund Favicon

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.

Cancel Application

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.

Confirm