Deaf registration form Tautoko Turi Request Support This video will help you register for SES support. Scroll or swipe up and down to cue sign video with questions. Q1. You want which? Face to face share story abuse in care? Face to face help write story abuse in care? Support find records from: Van Asche School Kelson deaf Education Center Social Welfare Mental Hospital Q2. Name Q3. Date of Birth Q4. Race / Iwi Māori Pākehā / NZ European Asian Pasifika Indian Other Q5. Email Address Why need Email? Q6. Deaf Contact Deaf to Deaf Alexandra Jon Q7. Contact How? Messenger Whats App Zoom Skype Teams meeting Q8. Hearing Person Contact? Yes No Q9. Contact How? NZ Relay (Phone interpreter) Interpreter Service Connect ISign WordsWorth Q10. Interpreter Name Interpreter number Contact Q11. Email contact in English? Yes No Q12. Email contact in Sign? Yes No Q13. Health problems have? Yes No Q14. Health problem what? Wheelchair user Epilepsy Cerebral Palsy Brain Injury Other Q15. Mental Health Issue Have? Yes No Q16. Mental health Problem what? Bipolar Depression Anxiety Trauma / PTSD Other Don't know Q17. Mental health Support have what? Medication Support Person Psychiatrist Q18. See SES - you comfortable where? Private room Deaf Club Motel Room Own Home Marae Zoom Other Q19. Where abuse happen? Van Asche / Sumner School Christchurch Kelston Deaf Education Auckland Foster Home Church person St Dominics Fielding School Thank you filling form Captcha You must enable JavaScript to submit this form Reset Submit If questions contact: Jon 022 525 1502 Nikki 027 615 6466 Alexandra 022 1099 485