3D Parent Brochure with Email address

Parent Enrolment form for 3D Coordination I wish to enrol my child in 3D Coordination.

Please contact me to discuss the 3D process.

Child Details

Last name:

First name:

Age: Date of Birth:

3D

3D

Coordination

Coordination

3D Coordinator Jan Glover RN

M/F:

Parent Information

Parent/Guardian/Carer Details

Last name: First name: Relationship to child: Address:

Email: Phone: Day: Other: Post, fax, phone or email these details to the 3D Coordinator at Kaitiaki Services.

Ph: Mob: Fax: Email: Address:

07 571 0144 027 207 1914 07 571 0154 3D@kaitiakiservices.co.nz 47 Fraser Street Tauranga South TAURANGA 3112

Hrs of work: 8.00am – 4.30pm Monday – Friday

Is a referral and information service for children with Developmental, Attention, or Behaviour Needs links families/whanau with available/appropriate services

3D Coordination will give feedback and recommendations to concerned parents and if appropriate will refer for further clinical assessment.

The family, a G.P., community agencies, education or health professionals can initiate the 3D process but a G.P. referral is required for 3D to refer to some secondary services.

3D will contact you to discuss the process.

Initially. 3D would like your permission to engage with the School or Early Learning Centre to gather information about your child or young person in that setting and then to arrange to meet with you to discuss the concerns you have.

This gathered information will be reviewed by the 3D Co-ordinator. Where a child’s difficulties are complex, 3D will seek advice from a multiagency team including Paediatrician, Child Development Services staff, an Educator, and a Public Health Nurse.

Parents, whanau: To enrol in 3D Coordination: Please fill out details on the other side of this form and post, fax, email or phone these details to 3D Coordination.

To be eligible for 3D Coordination Your child needs to be: 14 years of age or younger.

Living in the Western Bay of Plenty (bounded by Waihi Beach in the North, Otamarakau in the East and lower Kaimai ranges in the South).

Causing concern with learning difficulties or attention span.

Or causing concern with unusual or ongoing behaviour problems.

Your child should not be with: Maternal Infant Child Adolescent and Mental Health Services – MICAMHS. Ministry of Education ORRS.

3D will then provide recommendations and/or referrals as necessary to either hospital services and/or community organisations.

Ministry of Education, Learning Support.

The 3D Coordinator Kaitiaki Services 47 Fraser Street Tauranga South TAURANGA 3112

The role of the 3D Coordinator is to coordinate services so families can access support and if necessary, an assessment. Often a parent is concerned about a child’s development or behaviour and is not sure whether this warrants further investigation.