REFERRAL & ENQUIRY | Na Domo Ni Pasifika™

Na Domo Ni Pasifika The voice of the Pacific

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REFERRAL & ENQUIRY

Bula Vinaka and welcome

This form can be used to make an enquiry, request support, or refer an individual or family to Na Domo Ni Pasifika™.

All referrals and enquiries are reviewed through our initial screening process to determine whether NDNP is an appropriate service for your needs. Submitting this form does not automatically mean that a referral has been accepted or that a professional Service User relationship has commenced.

Information provided will be treated with respect and handled in accordance with our privacy and confidentiality requirements.

Communication & Record-Keeping
Initial referrals, enquiries and screening are managed in writing by email. This supports clear communication, accurate record-keeping, privacy, professional accountability and the safety of both the person seeking support and Na Domo Ni Pasifika™. Any change to communication arrangements will only occur where appropriate and after the relevant screening, consent and service documentation has been completed.

Please provide only the information needed for your initial enquiry or referral. More detailed personal or sensitive information can be discussed through NDNP's formal screening and intake process where appropriate.
Before submitting this form, please read our Privacy Policy & Confidentiality.

Referral & Enquiry Form

Name *

Email address *

I am contacting Na Domo Ni Pasifika to: *

Make a general enquiry
Request support for myself
Refer or enquire on behalf of a family or whānau member
Make a professional or agency referral

Type of service or support required *

Social Work & Advocacy
Coaching & Personal Development
Professional Supervision
Workshops & Community Training
General information or service navigation
Unsure – I would like guidance

Brief reason for your enquiry or referral *

Privacy, consent & referral acknowledgement *

I confirm that I have read and understood the privacy and referral information provided above. I consent to Na Domo Ni Pasifika™ using the information I submit for the purpose of reviewing and responding to this enquiry or referral. I understand that submitting this form does not mean that NDNP has accepted the referral or established a Service User relationship, and that initial communication and screening will be managed in writing by email.

Leave this field empty