Refer someone to our services Fill out the form Referral Form Who is making this referral?What agency are you from?Agency Working NamePhone number*Email addressEnquiry or referralDo you have client permission?YesNoOther information (e.g. reason for seeking counselling)Which service are you interested in?CounsellingParenting ToolboxGame OnBest StartSupervised ContactCommunity Social WorkSouth Dunedin CommunityOtherWho is paying for this service?Is this a requirement of a court order of FGC or Family/whanau agreement or other?What do you want from this engagement?Do you require a report? When is this due?If the client does not engage, do you require to be notified?YesNoClient's nameClient's date of birthClient's ethnicityClient's addressClient's email addressClient's phone numberClient NeedsClient's children/partnerOther agencies they are working withWorking/benefit/no income?Are you aware that we may be operating a waiting list and may not be able to immediately see your client? How we can help Counselling Individual Counselling Relationship Counselling Seasons For Growth Social Work Parenting The Parenting Toolbox Game On Parent Mentoring Grandparents Support Group Best Start Birth Support Group ABC Playgroup For Mums Treasured Wee Ones Community SupportDunedin Community Lunch Community Garden Holding on to Your Place Further Help SupervisedContact