Consent written or verbal by the family/whanau must be given, due to information sharing within agencies.
 
*Please note Aatea’s last panel meeting to discuss referrals is 15th December 2022. The next panel meeting is 09th February 2023 and you will be notified of the outcome.
Consent has been given by family/whanau to make referral? *

Child/Tamariki being referred:

Reminder: The criteria to be eligible for a referral to Aatea is that the child resides in the following suburbs (Homai/Clendon, Manurewa, Papakura and Takanini) and that they have multiple needs
Gender *
 
Ethnicity *
 
 +
Add Another Child?
Gender *
 
Ethnicity *
 
 +
Add Another Child?
Gender *
 
Ethnicity *
 
 +
Add Another Child?
Gender *
 
Ethnicity *
 
 +
Add Another Child?
Gender *
 
Ethnicity *
 
 +
Add Another Child?

Multiple needs of the taitamaiti/rangatahi

Does the tamaiti or rangatahi have any of these presenting issues? Please tick all that apply 🛈
 

Strength needs and desired outcomes:

Parent/Caregivers Details:

Gender *
 
Ethnicity *
 
 +
Add another parent? *
Gender *
 
Ethnicity *
 
 +
Add another parent? *

Current Agencies Involved:

Are there any agencies currently involved? *
Add Extra Agency?
Add Extra Agency?
Add Extra Agency? *

Referrer's Contact Details:

 +
Relationship? *
 
Kia Ora,
 
Unfortunately we cannot accept your referral if consent has not been given.
Please obtain consent prior to referring
 
Ngaa mihi nui,
Aatea
Powered byFormsite