How to Refer

Please use to below tab to access our referral form:

If clicked, the above link will ask you to save a MS-Word document to your computer for completion.

Once downloaded, you can open the document off your computer and enter content in the allocated fields. Once complete, save the document.

Once saved, you can send, along with supporting documentation:

a) Via email to Waipuna Hospice from HERE

b) Print & Fax to Waipuna Hospice
+64 7 552 4386

c) Print and post to Waipuna Hospice
43 Te Puna Station Road RD6, Tauranga 3176

Referral to Waipuna Hospice

Who Can be Referred to Waipuna Hospice?

Waipuna Hospice provides interdisciplinary specialist palliative care for patients and families, alongside the care provided by their GP and specialist teams. Our referral criteria are a guide for health professionals to understand who might be appropriate for referral to Waipuna Hospice services:

REFERRAL CRITERIA - Individuals should meet all of the below:


  • advanced, progressive disease which cannot be cured or the patient has refused treatment if competent to do so
  • complex problems including symptom control, psychological, social or spiritual issues important to the patient
  • the needs of the patient exceed the capacity of the primary provider alone and are best supported by a specialist hospice service
  • the patient agrees to referral if competent to choose
  • the patient is registered with a local primary healthcare provider and has New Zealand residency or reciprocal rights
  • if the patient is under 18 years old they are appropriately supported by specialist paediatric services
  • if the patient has non-malignant disease, supportive evidence of end-stage disease is provided


  • It is recognised that there are “grey areas” where individuals have needs but do not fit all the criteria above. These patients may be referred and will be discussed by members of the Waipuna Hospice referral team.

    It is also recognised that referral to Waipuna Hospice does not preclude involvement of other healthcare professionals. Waipuna Hospice aims to work in a supportive and collaborative way with healthcare teams.

    Waipuna Hospice acknowledges that “gaps” exist in current healthcare service delivery and it may be beyond the scope of hospice resources to meet these healthcare service provision gaps.

    This referral criteria is underpinned by the Referral Criteria for Adult Palliative Care Services in Midland Region - CLICK TO VIEW

    Who can make a referral to Waipuna Hospice?

    We welcome referrals to Waipuna Hospice from all health providers, including GP’s, hospital doctors, medical specialists and Iwi providers. If you feel that you, a family member or a patient you care for would benefit from Waipuna Hospice services, and the patient agrees to the referral, please speak to your GP or feel free to contact our Referral Team on (07) 5524380 to discuss.

    E-Referrals via Medtech or Mypractice

    Referrals can now be made directly from most GP practices via Medtech and MyPractice programmes. This is a fast and easy way to refer, and allows you to directly attach the most up to date patient notes and results. Quickstart guides on how to do this can be found below:

         

    Alternately, please feel free to contact our Referral Team on (07) 552 4380. We would be happy to discuss or provide an in-service for your staff on how to make an e-referral.