MENU
MENU
Home
About Us
History
Our Trustees
Our Hīkoikoi Management Limited Team
Owners Info
Education Grants and Scholarships
Te Rōpū Kaumātua
Te Tira Whakaritorito – Educating Ourselves Booklets
Change of Details Form
Te Rōpū Raranga o Manaia
Raumati Building at Hīkoikoi Available To Hire
Writing A Will
Tangihanga Bereavement Grant
Whare Mahana – Matiu Island Accommodation
Unclaimed Distribution
Annual Distribution
Home Insulation
Contact Details
FAQS
Information Data Privacy Policy
He Kohikohinga o Ngā Waiata o Taranaki
Assets
Property Developments
Commercial Property Portfolio
Student Accommodation
Residential Properties
Events
News
Publications
Annual Reports
Trust Deed
TTWMA
Newsletters
Consolidated Financial Statements
Ngā Tekau Alcohol and Other Drugs Service
Contact
Referral to Kaupapa Māori Alcohol & Drug Health Service
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Address
*
Phone
*
Email
Ethnicity
*
Gender
Iwi/Hapū
DOB
*
NHI Number
Dependents
Referral (only fill in if not self-referral)
Referred by
Organisation
Phone
Address
Referrers role
Level of contact
Emergency Contact Details
Layout
Name
Name
Phone
Addiction issues
How long has use been problematic?
Any other professional / Agencies currently involved?
Other relevant information
Layout
I hereby consent to the above information being made available to Ngā Tekau AOD Service
*
Agree
Date
Send
MENU
MENU
Home
About Us
History
Our Trustees
Our Hīkoikoi Management Limited Team
Owners Info
Education Grants and Scholarships
Te Rōpū Kaumātua
Te Tira Whakaritorito – Educating Ourselves Booklets
Change of Details Form
Te Rōpū Raranga o Manaia
Raumati Building at Hīkoikoi Available To Hire
Writing A Will
Tangihanga Bereavement Grant
Whare Mahana – Matiu Island Accommodation
Unclaimed Distribution
Annual Distribution
Home Insulation
Contact Details
FAQS
Information Data Privacy Policy
He Kohikohinga o Ngā Waiata o Taranaki
Assets
Property Developments
Commercial Property Portfolio
Student Accommodation
Residential Properties
Events
News
Publications
Annual Reports
Trust Deed
TTWMA
Newsletters
Consolidated Financial Statements
Ngā Tekau Alcohol and Other Drugs Service
Contact