West Coast | Healthy Homes Initiative

West Coast - Te Tai Poutini Referral Form

Refer to Te Tai Poutini below if you are in the West Coast rohe. Don't stress if you're on a border of West Coast, just refer and we can work out the best providers for you :)

Who is this referral for?

If you are referring on behalf of a whānau: Your name, organisation, and contact email/number

Whānau name

Whānau email

Whānau phone number

Whānau address/town

Whānau has a CSC

Whānau has a child under 6 living in my home

What home and/or health issues are the whānau dealing with? (i.e. mould, leaks, draughts, structural concerns, hospitalisations)

Address

Message Sent.

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