Hanen Interest - EarlyEd

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1 Step 1

Child's NameChild's first name

Child's NameChild's last name

Child's AgeDate of Birth

Parent's NameYour full name

Emaila valid email

Phone Number

Describe your child’s communication:

Language delay: not talking/few words ASD - not talking or starting to talk ASD - having conversations Other

Data consent

EarlyEd needs to collect information about you/your family so we can process your enquiry/booking.  This data will be stored electronically and securely on our client record management system, web and mail servers. It will only be used for the purposes of processing your interest in our services. EarlyEd ensures that your details are stored accurately and securely. You can have access to this information and withdraw consent at any time. EarlyEd only shares information with your consent unless the information is required or authorised by law.

Do you consent to the collection and storage of this information?

Confirm

Yes, I consent