Make a referral for yourself or someone who would like our support, anywhere within the Wairarapa region.

Referral form

Please fill in the details below and press submit when complete. Please also note, if the person you are referring requires palliative nursing involvement from Kahukura, please make contact with their GP or healthcare provider. People may self refer, though we would request permission to confirm diagnosis with your GP or specialist.

If you would like to download a PDF of this form please do so here and email through to referrals@hospicewairarapa.co.nz. All of the information you send through these forms is secure and confidential.

Our supportive care is tailored to individual physical, emotional, social, cultural and spiritual needs, and these factors are taken into account to help optimise the quality of life for our clients.

The services and resources available to you, a person in your care, a friend or someone your whānau include:

Please don't hesitate to call or contact us if you have any questions about our services or the support we offer.