Get Te Whiringa Ora Referral

Filling out the TE Whiringa Ora Referral form is an essential step for clients seeking support for their health conditions. This guide provides clear instructions on how to accurately complete each section of the form online, ensuring a smooth submission process.

Follow the steps to successfully complete the TE Whiringa Ora Referral form online.

1. Press the ‘Get Form’ button to access the referral form and open it in your preferred online editor.
2. Begin by filling out the 'Client Information' section. Provide the client's full name, preferred name, National Health Index (NHI) number, date of birth, address, contact details (home phone and mobile number), email address, gender, spoken languages, ethnicity, iwi (if identified), and occupation.
3. In the 'Next of Kin / Whānau Information' section, enter the name and relationship of the nearest relative or support person, along with their contact details.
4. Complete the 'General Practitioner Information' section by providing the GP's name, the practice they work at, and contact details for the practice.
5. Fill out the 'Medical Information' section with the client's diagnosis, relevant medical history, current medications, and any known allergies. Include recent health results and measurements as applicable.
6. In the 'Social Information' section, note any pertinent details such as substance abuse or recent life changes that may impact the client's health service needs.
7. Identify current service providers in the relevant section, listing any professionals the client is currently working with.
8. Finally, in the 'Referrer Information' section, enter the date of referral, your name, designation, and contact details. Ensure to sign the form before submission.
9. Once all sections are completed, save your changes, and choose to download, print, or share the TE Whiringa Ora Referral form as needed.

Complete your TE Whiringa Ora Referral online today to ensure timely processing of your request.