Only fill in this survey if you need a device if we go into Alert Level 3/4 .We may not be able to provide a device to every child that needs one and we will only give a maximum of 2 per family if we can. This survey will help us with our decision making.

You will need to be in a position to pick up the device if we go into Alert Level 3 and you will be contacted with details of where and when.  The pick up enables you to sign the agreement and for us to set up the correct device for your child.

Please complete this survey by 3pm Friday, 19 March