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HasM: false
Time Info:
Start Time Field: start_time_meta
End Time Field: null
Track ID Field: null
Time Extent: null
Time Reference: UTC
Time Interval: 0
Time Interval Units: esriTimeUnitsMilliseconds
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HTML Popup Type: esriServerHTMLPopupTypeAsHTMLText
enquiry_datetime (type: esriFieldTypeDate, alias: Date and time of assessment, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
rang_before (type: esriFieldTypeString, alias: Have you rung us before during this emergency?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
district (type: esriFieldTypeString, alias: What district are you in?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Far_North: Far North], [Kaipara: Kaipara], [Whangarei: Whangarei])
address (type: esriFieldTypeString, alias: Address for assistance (if different from affected address), SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
contactreason (type: esriFieldTypeString, alias: Why are you contacting us?, SQL Type: sqlTypeOther, length: 500, nullable: true, editable: true)
list_needs (type: esriFieldTypeString, alias: What are your needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
goodsother_type (type: esriFieldTypeString, alias: Type of household goods and services to be supplied by CDEM, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
confirm_contact_info_privacy (type: esriFieldTypeString, alias: Do you agree to details about your welfare needs and contact details being captured in this form?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
nationality (type: esriFieldTypeString, alias: What is your nationality?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [nationality_na: Not required], [nationality_nz: New Zealand (inlucing permanent residents)], [nationality_foreign: Foreign national], ... 1 more ...)
nationality_passport (type: esriFieldTypeString, alias: What countries passport did you use to enter NZ?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
embassy (type: esriFieldTypeString, alias: Can we share your personal details with your embassy/diplomatic mission?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
iwi (type: esriFieldTypeString, alias: Do you have any iwi affiliations?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
iwipermission (type: esriFieldTypeString, alias: Can we share your personal details with your iwi?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
totalnumber (type: esriFieldTypeInteger, alias: How many people in your whanau or group?, SQL Type: sqlTypeOther, nullable: true, editable: true)
adultnumber (type: esriFieldTypeInteger, alias: Number of adults, SQL Type: sqlTypeOther, nullable: true, editable: true)
childnumber (type: esriFieldTypeInteger, alias: Number of children and young people, SQL Type: sqlTypeOther, nullable: true, editable: true)
registerwhanau (type: esriFieldTypeString, alias: Can we please add these members to your registration?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
damage (type: esriFieldTypeString, alias: If your home has been damaged can we allow the building team to have access to your contact details to inform you of any building inspection outcomes?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
accommodationspecialreq (type: esriFieldTypeString, alias: Do you have any specific accommodation needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
accommodationnights (type: esriFieldTypeInteger, alias: Estimated number of nights needed, SQL Type: sqlTypeOther, nullable: true, editable: true)
accommodationlocation (type: esriFieldTypeString, alias: Where is accommodation needed?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
foodspecialreq (type: esriFieldTypeString, alias: Do you have any specific dietary requirements?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
foodpackagedays (type: esriFieldTypeInteger, alias: Estimated number of days food is needed, SQL Type: sqlTypeOther, nullable: true, editable: true)
waterspecialreq (type: esriFieldTypeString, alias: What do you need the water for?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
waterpets (type: esriFieldTypeString, alias: Do you have pets needing water?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
infantsupplyspecialreq (type: esriFieldTypeString, alias: Does your infant or toddler have any specific dietary requirements?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
infantsupplydays (type: esriFieldTypeInteger, alias: Estimated number of days essential goods are needed, SQL Type: sqlTypeOther, nullable: true, editable: true)
petfoodpettype (type: esriFieldTypeString, alias: What type of pets and how many of each?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
petfoodtype (type: esriFieldTypeString, alias: What food is required?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
petfoodspecreq (type: esriFieldTypeString, alias: Does your pet have any special dietary requirements?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
petaccessories (type: esriFieldTypeString, alias: Do you need any other pet accessories?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
petsupplydays (type: esriFieldTypeInteger, alias: Estimated number of days pet food is needed, SQL Type: sqlTypeOther, nullable: true, editable: true)
clothingpacktype (type: esriFieldTypeString, alias: What type of clothing is needed?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
cookingother (type: esriFieldTypeString, alias: Do you have any other cooking or dining needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
medicationspecreq (type: esriFieldTypeString, alias: Do you have any special medication needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
laundryneeds (type: esriFieldTypeString, alias: What type of laundry assistance is needed?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
hygieneequipmentspecreq (type: esriFieldTypeString, alias: Does anyone in your household need special assistance?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
wastedisposal (type: esriFieldTypeString, alias: Does your septic tank need emptying?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
wastedisposalsystem (type: esriFieldTypeString, alias: Is there anything we need to know about your septic system?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
wastedisposalspecreq (type: esriFieldTypeString, alias: Do you have any other waste disposal requirements?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
goodsdeliverytype (type: esriFieldTypeString, alias: What goods do you need delivered?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
gooddeliveryfrom (type: esriFieldTypeString, alias: Where do the goods need to be picked up?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
goodsdeliveryto (type: esriFieldTypeString, alias: Where do the goods need to be delivered?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
cdemaccessinfo (type: esriFieldTypeString, alias: Is there anything we need to know about access to your property for delivery?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
cdemtravelreason (type: esriFieldTypeString, alias: Why do you need to travel?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
transportspecialreq (type: esriFieldTypeString, alias: Do you have any specific transport needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
transportfrom (type: esriFieldTypeString, alias: Where are you travelling from?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
transportto (type: esriFieldTypeString, alias: Where are you travelling to?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
accommodation_needmet (type: esriFieldTypeString, alias: Has the accommodation need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
foodpackageneedmet (type: esriFieldTypeString, alias: Has the food package need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
waterneedmet (type: esriFieldTypeString, alias: Has the water need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
infantgoodsneedmet (type: esriFieldTypeString, alias: Has the infant goods need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
petfoodneedmet (type: esriFieldTypeString, alias: Has the pet food need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
clothingneedmet (type: esriFieldTypeString, alias: Has the clothing need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
beddingneedmet (type: esriFieldTypeString, alias: Has the bedding need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
cookingneedmet (type: esriFieldTypeString, alias: Has the cooking need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
fuelneedmet (type: esriFieldTypeString, alias: Has the fuel need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
medicationneedmet (type: esriFieldTypeString, alias: Has the medication need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
hygieneneedmet (type: esriFieldTypeString, alias: Has the hygiene and cleaning need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
toiletneedmet (type: esriFieldTypeString, alias: Has the toilet and washing need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
wastedisposalneedmet (type: esriFieldTypeString, alias: Has the waste disposal need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
goodsdeliveryneedmet (type: esriFieldTypeString, alias: Has the goods delivery need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
transportneedmet (type: esriFieldTypeString, alias: Has the transport need been met?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
needmetexp (type: esriFieldTypeString, alias: Please explain why needs could not be met, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
status (type: esriFieldTypeString, alias: Status, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [resolved: Resolved], [inprogress: In progress], [casemanagement: Case management required], ... 2 more ...)
contact_details (type: esriFieldTypeString, alias: Please provide a way to contact you., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
same_address (type: esriFieldTypeString, alias: Is the address for assistance the same as the affected address?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
advice_given_missingperson (type: esriFieldTypeString, alias: What advice was given?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
childprotect (type: esriFieldTypeString, alias:  , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [childprotect: Care and protectection for children and young people])
advice_given_childprotect (type: esriFieldTypeString, alias: What advice was given?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
advice_other (type: esriFieldTypeString, alias: What advice was given?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
cdemaction_no_record_info (type: esriFieldTypeString, alias: Record information for CDEM for this situation, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
waternote (type: esriFieldTypeString, alias: Additional information about water needs, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
petfoodspecialreq (type: esriFieldTypeString, alias: Additional information about pet needs, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
no_needs (type: esriFieldTypeString, alias: Are there any needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
other_fieldassessor (type: esriFieldTypeString, alias: Other Field Assessor Agency, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
referral_accomm_otheragency_notes (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referral_food_otheragency_notes (type: esriFieldTypeString, alias: Food package notes for advice or referral., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referal_househld_otheragent_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referal_goodsdelivery_otheragency_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referral_financial_otheragency_note (type: esriFieldTypeString, alias: Financial notes for advice or referral, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referral_pets_otheragency_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referal_psychosocial_otheragncy_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referral_meddisability_otheragency_note (type: esriFieldTypeString, alias: Medical disability service notes for advice or referral, SQL Type: sqlTypeOther, length: 100, nullable: true, editable: true)
referral_support_care_otheragency_note (type: esriFieldTypeString, alias: Support and care service for advice or referral, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referral_transport_otheragency_note (type: esriFieldTypeString, alias: Transport notes for advice or referral, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referral_inquiry_otheragency_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
referal_childprtect_othragncy_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
refferal_other_agency_note (type: esriFieldTypeString, alias: If a referral was made to another agency, please add some notes here for CDEM., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
overall_priority_cdem (type: esriFieldTypeString, alias: Overall Priority for needs set by CDEM. , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [P1: P1], [P2: P2], [P3: P3], ... 2 more ...)
english_spoken (type: esriFieldTypeString, alias: Are you able to understand and communicate in english?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
privacy_statement (type: esriFieldTypeString, alias: During this needs assessment, the local Civil Defence Emergency Management Group will collect information from you in order to provide support to you or your family / whānau throughout this emergency.
privacy_statement1 (type: esriFieldTypeString, alias: If necessary to meet your need, this information will be shared with our staff and potentially with other Government agencies and non-government organisations that provide support in emergencies.
privacy_statement2 (type: esriFieldTypeString, alias: If you do not wish to provide us with your information then we may not be able to provide some types of assistance. We can provide you with information about other sources of assistance.
privacy_agree (type: esriFieldTypeString, alias: Do you agree to the details you provide about your welfare needs being captured in this form?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
resolved_by_name (type: esriFieldTypeString, alias: Name of Resolver, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
resolved_by_phone (type: esriFieldTypeString, alias: Phone number of Resolver, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
stayin_centre (type: esriFieldTypeString, alias: Are you using the centre?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [stay_overnight: Stay at centre overnight], [use_facilities: Using facilities at centre])
privacy_no (type: esriFieldTypeString, alias: If there is no agreement to share contact details we can only supply advice or referral, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)