Self-Referral Forms

Breastfeeding Advocate Referral Form

Breastfeeding may be natural, but that doesn’t mean it always comes naturally!  There are plenty of scenarios that can make breastfeeding harder and getting the right information and support is vital.  If you need help working through a breastfeeding challenge or have questions about anything related to breastfeeding, Breastfeeding Advocates Erin and Raewyn would love to hear from you.

The West Coast PHO Breastfeeding Advocate team accept self-referrals.  It’s simple – all you have to do is fill in this form and one of our team members will be in touch. Take advantage of this FREE service today! For more information about the Breastfeeding Advocates, click here http://www.westcoastpho.org.nz/breast-feeding

Nutrition Self-Referral Form

The West Coast PHO Dietitian Service is now accepting self-referrals.  It’s simple – all you have to do is fill in this form and a dietitian will be in touch. Take advantage of this FREE service today!

If you want to learn more about the Nutrition Services the PHO offers then click here

 

Green Rx Self-Referral Form

The WCPHO Green Prescription team supports being active as an opportunity to enhance physical, mental and social wellbeing. Green Prescription provides support and motivation to increase your physical activity levels. This free service provides the guidance to get started - and get active, whether you are new or returning to physical activity.

The West Coast PHO Green Prescription team are now accepting self-referrals.  It’s simple – all you have to do is fill in this form and a one of our team members will be in touch. Take advantage of this FREE service today!

Youth-Mental Health Referral Form

The PHO is providing Brief Intervention Counselling for mild to moderate mental health problems, not only for adults but for youth as well, and it’s a FREE service. Good health includes physical, emotional, mental, social, and spiritual wellbeing.  This programme can assist youth with emotional and mental fitness. We are available to cover areas coast wide from Karamea to Haast.  Youth can self-refer to our programme, or can be referred by GP’s, nurses, family members or school teachers. Please note: This online referral form is for referring youth only. All adults (18+) must be referred by the GP Practices and filling the online referral form will not be accepted as referral.