Referrals to the PHN Service

PHN Service Referral forms

GP's are able to refer via ERMS.

Please supply full address details incl. post code on all referrals.

Public Health Nursing Service Referral C110025

Instructions for using writeable version referral form:

  1. Click the file to open in Adobe Acrobat reader OR right-click>save target as>save the file to your computer

  2. Complete all fields on the referral form

  3. Note: when signing the form if you do not have a digital ID simply add your name in the signature field and leave the other digital ID field empty

  4. On completing the information on the form, save the form - if possible, when doing this type the patients' name in the filename so that it can easily be referenced

  5. Email the PDF file as an attachment to phnburwood@cdhb.health.nz

 

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Page last reviewed: 07 September 2015
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