FAMILY / WHĀNAU MEMBER REFERRAL FORM
Fields with an asterisk (*) are compulsory. Please read this before submitting a referral:
 

  • We offer therapy (with a psychologist or psychotherapist) supported by a Doctor (MOSS Psychiatry for ages 17yrs +) where needed. Our Doctor is a mental health GP and not a psychiatrist and we are not able to offer psychiatry only services.

  • If someone is wanting a Psychiatric assessment or medication monitoring only please contact a service that offer this such as Practice 92.

  • Our service doesn't specialise with ADHD and can't offer ADHD assessment or ADHD medication. Practice 92 or Dr Tony Hanne may be options or to search for other providers visit Home | Healthpages or Healthpoint.

  • KIDS and YOUTH: Our in-person Child Psychotherapist is fully booked and we are not able to add people to her waiting list at this time while in Alert Level 4.

  • Our online (ZOOM) Child Psychologist is able to see children and young people with low risk and has some availability at this time Monday to Friday.

  • Our specialist mental health GP can see ages 17 years and older only and doesn't prescribe meds for ADHD.

  • Our adult psychologists may be able to offer therapy for people who are experiencing anxiety and who have low - moderate risk to their safety.

  • We are offering online appointments only at Level 4 and 3.

  • Depending on a person's needs and the resources available at Anxiety NZ the wait to see a psychologist may be 1 - 6 weeks.

    We may not be able to offer an appointment to all people wanting 1:1 therapy due to the support we provide, and the resources we have available at the time. 

    Anxiety NZ is not a crisis service for people experiencing urgent or high risk to their or others health or safety. If you need help urgently please visit I Need Help Now | Mental Health Foundation

Thank you for your understanding as our team work hard to continue to provide services under Alert Level changes. 

Contact us for more information.

What is their gender?*
Will another referral from a GP, Counsellor, or Mental health worker be sent to us?*
Does the person agree to you making this referral?*
If this person is a minor, are they in your care?*

If someone is in immediate danger, please dial 111 for ambulance assistance. Or phone your local DHB Mental Health Crisis Team (CATT Team), for a list of numbers call Healthline 0800 611 116

Referral sent

If you prefer, you can download a printable form for emailing here.
Email your completed form to: reception@anxiety.org.nz

For help in a Crisis:

https://www.mentalhealth.org.nz/get-help/in-crisis

If you are worried about the safety of a loved one, or someone else you can call the Crisis Team on 0800 800 717 or dial 111 in an emergency. 

 

For more information about helping family / whānau:

https://www.mentalhealth.org.nz/get-help/in-crisis/worried-about-someone/

Do you need support?

Formerly known as Supporting Families NZ, Yellow Brick Road is a national organisation that provides support for whānau who have a loved one experiencing mental health challenges. Mental health support for families - Yellow Brick Road

 

For any referrals coming through from medical or counselling professionals, please have these either faxed (09 849 2375) or emailed to reception@anxiety.org.nz