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

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  4. PPNAP Referral Form - South Canterbury
  1. What we offer

PPNAP Referral Form - South Canterbury

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

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

Referrer's responsibility

Note: Clients will be contacted within 14 working days after 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

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