To refer someone to our Services, please use the forms below

For how to access our services and how to get or make a referral, click the appropriate form below, or view Our Services. Please note that for some services, we can only accept referrals through a specified pathway, as contracted under the Canterbury District Health Board. Ask your GP for more information.


All bed-based admissions will be Covid screened – download the form here.  This includes Respite (Planned and Crisis), Adult Residential, and Youth Residential.  Visitors will also be Covid screened – download the form here.  Note: those staying at Respite (Planned and Crisis) and all Visitors are required to wear a mask.


  • Adult Residential service (including enhanced mobile options) – referrals can be made by Specialist Mental Health Services, via CDHB ROSC, by sending an email to or Ph: 03 363 1950 ext. 33680.
  • Crisis Respite service – GPs and Specialist Mental Health Services can make a referral using the Adult Crisis Urgent Respite – Referral Form.

For those making referrals: please look at the CHECKLIST for Referrers – Adult Crisis Respite Admission Requirements.

Youth Residential, Youth Respite, Youth Mobile, or Youth Community Support Work services

To refer a young person aged 14-24 for the above, please use the following forms.

Community Youth Mental Health Service – to refer a young person aged 14-18 please use the SST Youth Services – Referral Form.

Mobile Medication Service – To refer either a Youth or Adult, please use the MMS – Referral Form.

MindWise – Referrals are currently being accepted – see the MindWise page.

Caroline Reid Family Support Service – To refer a child/young person aged 7-16 – see the Caroline Reid page.