Home/Get support/Ask or apply for help/Economic harm support form Economic harm support Our economic harm specialists can provide support with the financial challenges family violence. Economic harm support Please enter your details below if you would like to reach out to our Family Violence Economic Harm Specialist via our contact form. Step 1 of 2 50% Name* First Last Date of birth* Day Month Year Gender*FemaleMaleGender diversePrefer not to sayEmail* Phone* Where in New Zealand are you based?*Select optionAucklandBay of PlentyCanterburyGisborneHawke's BayManawatu-WhanganuiMarlboroughNelsonNorthlandOtagoSouthlandTaranakiTasmanWaikatoWellingtonWest CoastAre you completing this on behalf of a client?* Yes No Name of organisation* Your name* Your phone number* Your email address* Please tell us a little bit about youThis helps us ensure different groups within New Zealand are hearing about our services. Ethnicity Māori New Zealand European Other European Samoan Cook Islands Māori Tongan Niuean Tokelauan Fijian Other Pacific Peoples Southeast Asian Chinese Indian Other Asian Middle Eastern Latin American African Other Prefer not to say Please specify* How did you hear about our service?Select optionSocial mediaOur websiteFriend or familySearching onlineThrough another organisationThe newsOtherPlease specify* Please specify* PhoneThis field is for validation purposes and should be left unchanged.