Te Rangihaeata Oranga Trust

Hawke's Bay Gambling Services

Referral Form

 
If you have reason to believe someone may need help with problem gambling, fill out the form below to submit a referral form to Te Rangihaeata Oranga Trust/Hawke's Bay Gambling Services.

* Required Data

Client Details

How did you hear about the service?

Referrer Details

Identified Mental Health Issues

Justice Issues

Other Agencies/Health Professionals known to be working with the client:

Consent to Contact