Online Referral Forms

If you or the family/whānau you are working with meet the Referral Criteria and you would like to refer yourself or them, you can complete the online forms below.

Early Start will inform the referrer within two working days if the family/whānau have been accepted or declined into the programme.  Please ring the office on 0800 378-278 if there is a delay in you receiving a response or if you have any questions.

Agency Referral Form
This form is to be completed by agencies.

Family Start Transfer Report
To be completed when a Family Start family requests a transfer to the Early Start programme.

Self Referral
This form is to be completed by a family/whānau member seeking self referral for their family/whānau.