Patient Referral Form

Please complete the form below to book a patient to see one of our Nurse Educators.

Please note: We are currently only accepting referrals for patients living in Waitemata, Auckland Central, and for the Wellington region, Capital & Coast geographical areas previously represented under the New Zealand Public Health and Disability Act 2000.

Also note: We are currently unable to offer Spirometry Testing. Please ignore any Spirometry references on this form

Once completed and submitted, a Nurse Educator will contact your patient to arrange the best time to see them.

 

(If booking a Spirometry Test, please see note at bottom of the page.)

Please note: If you refer yourself or are referred for a Spirometry Test at Asthma New Zealand, these tests are conducted only in Auckland for the time being.