If you or the person you are referring is eligible for support from Connections & Funding, please complete the referral form below (previously called a “Needs Assessment” or “NASC” referral).
Referrals can be made through our online form or through email.
If this is your first time working with us, please ensure your doctor or specialist completes the Confirmation of Diagnosis Form (see below). Please note that we cannot proceed with a referral without a completed Confirmation of Diagnosis.
Make a Referral Online:
Downloads:
Once completed email your form/s to [email protected]
You can also email any questions to [email protected] or call us on 0800 758 700 between 8.30am and 4.00pm weekdays.
Who can make a Referral?
You can apply yourself using our Self-Referral Form. We can accept Referrals on your behalf from any of the following people. They will need to complete the Referring Someone Else Form.
- a whānau / family member
- a friend
- a carer
- a disability support organisation
- a doctor or health professional.
Anyone making a referral must have the permission of the person referred. Parents or caregivers can refer children and young people aged under 18 using the Self-Referral Form.
To check if you’re eligible for our service, view our who we support page via the link below.
Phone 0800 758 700
What happens next?
We will check that you are eligible and be in touch within five working days to set up a time to meet. If you’re not eligible for our service, we will help direct you to another service or provide advice on the next step.
If you’re eligible, a Community Facilitator will work with you to develop a Living Well Plan that identifies what it means for you to live well – what supports or equipment you may need, and what you want to do to achieve your goals. These goals may be large or small.
A Living Well Plan is led by you, at the place you want to meet and with any support (family / whānau, friend, advocate or caregiver) you choose. Let us know if you would like us to organise cultural support or interpreter services, including a NZSL interpreter.
Our team will then connect you to organisations, groups, or people who can help make your Living Well Plan a reality.
If you have an urgent need, we will work to address that first.
