• PlunketLine PlunketLine
  • 0800 933 922
  • Appointments and enquiries Appointments
  • 0800 184 803
Find Plunket near me Find us
  • PlunketLine PlunketLine
  • 0800 933 922
  • Appointments and enquiries Appointments
  • 0800 184 803
Find Plunket near me Find us

Donate
  1. Home ›
  2. Whānau Āwhina Plunket and services ›
  3. What we offer ›
  4. PPNAP Referral Form - Canterbury
  1. What we offer

PPNAP Referral Form - Canterbury

Please fill out this form to refer your client to our Plunket Perinatal Adjustment Programme (PPNAP). Whānau are also welcome to self-refer.

Please note this form is only to be used for Canterbury-based clients. Please use the separate forms for South Canterbury or Dunedin-based clients.

Referrer's responsibility

Note: Referrals are allocated once a fortnight. Clients will be notified by email within 14 working days from receipt of referral.

Mother's details

Details of baby and other children

Partner's details

Referral/assessment details

Please tick if any of the following are present and provide details in the box below

*If the client is involved with another specialist mental health service, the referral will be declined

Referrer's Details

We use cookies to improve your experience on our site and to show you personalised advertising.
Show me more info