Mobile Clinic

Referral Website

If you would like a homevisit for yourself or whanau, please complete the form below.

Please click here to see a list of other services offered by the Mobile Clinic.

Once the form is received, we will make contact with the whanau/individual.

If there are any issues our team will contact the REFERRER.

REFERRER CONTACT - First Name:

REFERRER CONTACT - Last Name:

REFERRER CONTACT - Phone number:

REFERRER CONTACT - Email

Is the referral for:

Family

Individual

FAMILY / INDIVIDUAL CONTACT - First Name

FAMILY / INDIVIDUAL CONTACT - Last Name

FAMILY / INDIVIDUAL CONTACT - Phone number

FAMILY / INDIVIDUAL CONTACT - Email

Services required

Covid-19 Swab

Vaccine

Other (provide details below)

Other services required

Anything else we should know?

Screening and assessment

Vaccinations

Post discharge follow-up (ED & Wards)

Co-ordination of necessary primary and secondary care, e.g., GP care, follow up of outpatient appointments.

Triage & Referrals

Social services, e.g., Housing, Food banks or WINZ services
Secondary services: referral and follow-up Mental Health
Assessments and treatment or referral to appropriate service provider Pharmaceutical
Facilitate and support medication reconciliation

Services offered by the Mobile Clinic