Tohutoro Kaiwhaiwhai
Referral Form

I hereby give consent to CRC Ltd and applicable representatives thereof, to obtain verbal and or written reports on myself from stake holders and Services i.e., Oranga Tamariki, ACC and Ministry of Health as deemed appropriate and or necessary.

I understand that any information given, by any of the agencies will be held in strict confidence within the confines of the CRC Ltd Services. That neither CRC Ltd and or any representatives thereof are at liberty to release any information, to any other service or agency without my express permission to do so.