Referral Forms

Need help now?

If you are in immediate danger dial ✆111.

If you are not in immediate danger, but need help, call ✆0800 28 48 26 to speak to one of our team. You do not need to fill out a referral form to access support.

 

Referral Forms

If you work with children or families in Canterbury and would like to refer someone to Aviva, please fill out the appropriate referral form below and email it to referral@aviva.org.nz.

Referral form for people experiencing violence

Sexual assault support referral form

Tamariki referral form

Rangatahi/youth referral form

ReachOut referral form - for people using, or at risk of using violence

Seuga referral form - for Pasifika people

Whānau Resilience referral form

 

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