Referral portal
Dementia NZ website

Make a referral

Refer someone to Dementia New Zealand support – or refer yourself. Your information is encrypted and handled in confidence to arrange the right support.

Test mode — this is a preview. Anything submitted here is a test, not a real referral.
  1. Referral
  2. Personal details
  3. Clinical & consent
  4. Review

Step 1 of 4

Referral

Your information is sent securely and only accessed by authorised Dementia New Zealand staff and the local Dementia organisation supporting your area, to arrange support.

We use the details you provide only to arrange dementia support for the person being referred – which may be you.

The portal copy is scheduled for secure deletion 30 days after submission. The local organisation may transfer necessary information into its service record and retain that record under Dementia New Zealand's privacy policy. Access is restricted to authorised staff and application access is logged. Handled under the Health Information Privacy Code 2020 (HIPC 2020).

Read our full privacy policy

Who is getting in touch?