Professional Referral Form

Refer someone in your care

If you’re a healthcare professional, you can refer a patient or client to our Dementia New Zealand Network for further information, advice and support using the below form.

If you are living with dementia, or you are concerned about someone close to you, you can submit a Carer/Whānau Self Referral Form to our team. A Dementia New Zealand Network staff member will be in touch to discuss community services and support available in your area.