Fire and emergency Dispute Resolution Scheme Application Form

Please use this application form if you wish to apply to use the Fire and Emergency Dispute Resolution Scheme.

To apply to use the Fire and Emergency Dispute Resolution Scheme, please complete the form below. If you need any assistance, feel free to contact us on (09) 486 7140 or Freephone: 0508 ICRA REVIEW (427 273). or by email to casemanager@icra.co.nz. Our case management staff are here to help you.
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In most cases, you need to attempt to resolve your dispute via a Fire and Emergency complaint process. There are however exceptions. If you’re not sure how to proceed, please feel free to contact us before completing the application.
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Have you attempted to resolve this dispute with Fire and Emergency through another complaint process?
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Please upload a copy of the complaint outcome (if any)
Upload your documents...
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Please give a brief explanation as to why you have not attempted to resolve this complaint through any Fire and Emergency complaint process
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Are you making this application on behalf of another person?
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Where you make an application on behalf of an applicant, whether the applicant is an individual, company, or other entity, you must satisfy the Scheme Administrator that you are authorised to make the application on behalf of the applicant.
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Your First Name
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Your Last Name
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Your E-mail Address
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Your Phone Number
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Organisation
Name of your organisation (if any)
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Nature of your authority to make application
Please explain why you are authorised to make this application on behalf of someone else
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Documentation confirming your authority
Please upload any relevant documents confirming your authority to make this application on behalf of someone else
Upload your documents...
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Applicant's First Name
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Applicant's Last Name
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Applicant's E-mail Address
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Applicant's Phone Number
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Applicant's Organisation
Name of the relevant organisation applicant is a part of (if any)
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Is the applicant applying in the capacity of a member of the public or a volunteer?
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Applicant's Location
  • - select a option -
  • Northland | Te Tai Tokerau
  • Auckland | Tāmaki-makau-rau
  • Waikato
  • Bay of Plenty | Te Moana-a-Toi
  • Gisborne | Te Tai Rāwhiti
  • Hawke's Bay | Te Matau-a-Māui
  • Taranaki
  • Manawatū-Whanganui
  • Wellington | Te Whanga-nui-a-Tara
  • Tasman | Te Tai-o-Aorere
  • Nelson | Whakatū
  • Marlborough | Te Tauihu-o-te-waka
  • West Coast | Te Tai Poutini
  • Canterbury | Waitaha
  • Otago | Ōtākou
  • Southland | Murihiku
- select a option -
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Field is required!
If there are additional applicants, you can add them by selecting the '+' icon.
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Field is required!
In the next section we ask you to provide us with the relevant contact details for any other parties to the dispute.
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Field is required!
Other Party's First Name
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Other Party's Last Name
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Other Party's E-mail Address
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Other Party's Phone Number
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Field is required!
Other Party's Organisation
Name of the relevant organisation the other party is a part of (if any)
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Field is required!
Other Party's Location
  • - select a option -
  • Northland | Te Tai Tokerau
  • Auckland | Tāmaki-makau-rau
  • Waikato
  • Bay of Plenty | Te Moana-a-Toi
  • Gisborne | Te Tai Rāwhiti
  • Hawke's Bay | Te Matau-a-Māui
  • Taranaki
  • Manawatū-Whanganui
  • Wellington | Te Whanga-nui-a-Tara
  • Tasman | Te Tai-o-Aorere
  • Nelson | Whakatū
  • Marlborough | Te Tauihu-o-te-waka
  • West Coast | Te Tai Poutini
  • Canterbury | Waitaha
  • Otago | Ōtākou
  • Southland | Murihiku
- select a option -
Field is required!
Field is required!
If there are additional parties to this dispute, you can add them by selecting the '+' icon.
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Field is required!
Please provide a brief description of the dispute
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What outcomes are sought by the applicant?
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Is there anything else we should be aware of at this stage?
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What process would you prefer to use to resolve your dispute?
  • - select a option -
  • Facilitation
  • Mediation
  • Adjudication
  • Fast-track adjudication
  • I don't know
- select a option -
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Fast-track adjudication is available for time critical matters only. Please provide a brief explanation as to why this dispute is time-critical.
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I confirm that the information I have supplied is true and correct to the best of my knowledge
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I confirm that I have read, understood and accepted ICRA's Terms and Conditions
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