Kirikiriroa Family Services Trust (KFST) Referral Form

Nau mai haere mai,
Kia ora, ko whero toku ignoa and I will be here to awhi you through your referral.

Please fill in the form below and tell us a little bit about your situation to make a referral.

Once we’ve received your referral, someone will be in touch to arrange for a visit at a time and place that works for you.

Tell us about yourself

Tell us about the hapū māmā, tamariki or rangatahi

Additional Tamariki/Child

How can we help?

Nga mihi,
We know how valuable your information is and appreciate the time you have taken to complete this form.
By submitting your information you give us the consent to make contact with you.
All information provided will be kept confidential by KFST and used for the sole purpose of assisting you to appropriate supports.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Call Us To Refer

You can also contact us direct and we can receive referrals over the phone.

Download Referral Form

You can also download and print off the referral form and email it back to us, post it or bring it in to us.