Apply for support

Any family/whānau living on Waiheke with a child up to 18 years old who has a health need, is eligible for assistance. Applying for support is strictly confidential.

Please complete our online application form below with the details of your request. All requests will be considered, no matter how big or small.

Application Form

Child's Name

First Name

Last Name

Child's Date of Birth

Enter in in day/month/year format

Parent/Caregiver Name

First Name

Last Name

Contact Email

Contact Phone Number

Home Address

Child's Health Condition

Please provide a short description of your child's diagnosis or health condition.

Has your child's condition been diagnosed by a doctor or specialst?

Yes

Doctor's Details

Please provide details of the doctor or specialist currently treating your child.

What do you need help with

Please provide a short description of the support you are seeking from the Jassy Dean Trust.

What are the costs?

Please provide the cost of each item of support requested (eg approximate or actual cost of treatment per session.)

Do you require ferry tickets?

Ferry tickets may be requested for your child's health appointment in town. We appreciate the support from Fullers and Sealink.

Yes - Fullers

Yes - Sealink passenger only

Yes - Sealink car and passenger

How many adult and child tickets will you need?

Date of Appointment

Reason for Appointment

Details of payment

Please provide the name of the agency providing treatment and contact details for payment. Otherwise please provide bank account details if payment will be directed to parent/caregiver.

Other support

Please provide brief details of other support being accessed for your child, if applicable.

Other relevant information

Please provide any other information to help us understand your child's situation, if applicable.

Name of person applying

Provide the name of the person completing this application form, if different from parent/caregiver.

First Name

Last Name

Email of person applying

Provide the email of the person completing this application form, if different from parent/caregiver.

Unless urgent, all applications will be reviewed by all trustees at a monthly meeting. A Jassy Dean Trust representative will be in contact once your application has been reviewed and a decision made.
For any questions about the process or if you have time sensitive requests do let us know via the Contact Form.

Emergency

In case of an emergency, ask your local Doctor how the Jassy Dean Trust can help, emergency packages (including emergency cash & ferry tickets) are issued through all local medical centres.

The Waiheke Health Trust 09 372 8893
Ostend Medical Centre 09 372 5005
Waiheke Medical Centre 09 372 3111
Piritahi Hau Ora 09 372 0022
Citizens Advice Bureau Oneroa

Alternatively contact Trustee Jude Denny on 021 024 88377

The different ways we can support…

Financial assistance for medical appointments, treatment, medication and equipment

Cash grants when your tamariki is in hospital
Fullers and Sealink ferry tickets for hospital visits and appointments
St John’s ambulance or Westpac Rescue Helicopter fees
Therapy and counselling
Neuro-developmental programmes for children and youth with disabilities
Music or animal therapy
Assistance with baby sleep and feeding issues
Complementary natural health treatments and osteopathy
Fundraising campaigns for therapy dogs or larger equipment