REFERRAL

REFERRAL FORM

 

 

PLEASE NOTE OUR OFFICES WILL BE CLOSED FROM 14TH DECEMBER, 2018 - 14TH JANUARY 2019.

WE WILL NOT BE ABLE TO RESPOND TO ANY REFERRALS OR INQUIRES EITHER BY PHONE OR EMAIL UNTIL THE 14TH JANUARY, 2019

WE WISH EVERYONE A HAPPY AND SAFE HOLIDAY SEASON

 

 

Please complete all areas of the referral form. Note: This form is sent to all parties when initially contacted by us.

1 - A $20 application fee applies. please pay into bank account number 38-9017-0777546-00

2 - if payment of the application fee is a problem, please get in touch with Tracy at tracy@mediationservices.org.nz.

Referral