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Hawkes Bay - Child Healthy Housing Programme Referral Form

Refer to the Child Healthy Housing Programme below if you are in the Hawkes Bay rohe.

Client (Child) information

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If child is under 19 fill out guardian information

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Please note the referral criteria are as follows: located within the greater Hawkes Bay area; whare with a child under 19 years of age (residing or regularly visiting); pregnant māmā; child with respiratory illnesses; individuals at risk of rheumatic fever or rheumatic heart disease (including recurrent GAS positive results); whānau receiving benefit.

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Referrer details

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Informed consent: I/we give informed consent for the following -

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Thank you for reaching out. Someone from Child Healthy Housing Programme will be in touch with you about this referral.