Professional Referral Form

Professional Referral Form

Do you wish to refer your client to Home & Family Counselling?

 

Who can make a referral:

Healthcare Professionals – such as a General Practioner (GP), specialist medical practitioners, or any other community social service.

Information Required:

Our aim is to provide the best service and support for your client(s). Providing us with as much information as possible about your client(s) prior to their appointment will assist us to provide the best support we can. Only Home & Family Counselling will have access to this information.  Your responses will be kept private and secure.  The information will not be used for a discriminatory purpose.

What is the referral process?

Due to high demand, Home and Family Counselling does run a waitlist.  We will be in contact with your client as soon as we have an appointment available.  In the interim, we will contact your client and request them to complete a Request For Counselling Form‘ either online or alternatively provide the information over the phone to one of our receptionists, so we can start to match their counselling needs with one of our counsellors.  You are welcome to phone us for an update on the waitlist, or if you seek further information about our services:

      • Central Centre: Phone (09) 630 8961
      • North Shore Centre: Phone (09) 419 9853
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We aim to make our counselling accessible to all. To help offset some of the costs of the counselling services provided, we ask clients to make a voluntary contribution based on their total household income to Home & Family Counselling for each session. Refer to the Voluntary Contribution Guidelines. Note: family sessions can be up to 1.5 hours in length, and all voluntary contributions are negotiable.

IMPORTANT!

Home & Family Counselling is not a crisis centre and our office opening hours vary.  If you have grave concerns for your client’s safety or the safety of others please contact the Mental Health Crisis Team [Central Auckland – Phone 0800 800 717 or North Shore – Phone 09 486 8900}.

REFERRAL FORM