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Provider Referral

Complete this form if you are a referring healthcare provider

 

Provider Referral

Download Referral Form
Provider Referral Form

Whānau Details


Alternative Contact


Whānau Expecting a Pēpī

if the referral is for hapūtanga support


Tamariki Details

if the referral is for a Tamariki


Safety Concerns


Immediate Needs


Please tick the service/s required below:

If you do not know what service to refer to that is ok, we will connect the whānau to the most suitable service/s based on the information provided in the immediate needs section.


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0800 004 554
reception@tearawawhanauora.org.nz
referral@tearawawhanauora.org.nz
1231 & 1218 Haupapa Street, Rotorua
1252 Eruera Street, Rotorua
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