Referral Form

Maataa Waka Services and criteria

Our services are available for all ethnicities

  • Social Service (for whanau with children under the age of 17)

  • Youth Social services – one to one & group programmes (12-17 years)

  • Attendance (Truancy) Referrals only accepted via schools (School aged Tamariki/Rangatahi)

  • Stopping violence and safety programmes for Men, Women and Youth - one to one and/or group

  • Building Financial Capabilities (Financial mentoring one to one and/or group programme)

  • Tiramarama Mai (Alternative Education) Year 12 and 13 students - Group Programme

  • Whanau Ora Navigator –Supporting whanau to identify and achieve goals and aspirations

Referrer Name *
Referrer Name
Please note that we cannot accept a referral without the permission of the person referred
Client Details
Name
Name
Sex
Date of Birth
Date of Birth
Whanau Details – Parent / Caregiver / Spouse / Next of Kin
Date of Birth
Date of Birth
Date of Birth
Date of Birth
Support Required
Please tick the areas that you require support with