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Addictions Recovery Palmerston North Online Referral Form

Section 1:  Your details

Let us get to know you a little.  Tell us some basic details about you

Now let us know how to best get back to you

How do you prefer to be contacted?
Section 2:  Your Current Status is

Let's find out a little more about you 

Do you have any children in your care?
Is there any Oranga Tamariki (CYFS) Involvement?
Are you on EM Bail?
Are you engaged with any other Mental Health or Addiction Recovery Services?
Are you engaged with Community Corrections/Probation?
Do you have any pending charges with the Courts?
Do you have any medical or mental health concerns?
Any additional support required
Section 3:  How we can support you?
What substance/s are you (or have you been) using
?

Services we Provide

 

Community Day Programme

The eight-week Monarch Programme is an educational and life skills based programme that addresses addiction, mental health and social issues.  The community option is recommended for people who have healthy support in the community or are unable to leave their home.  Attendance of the programme is Monday – Friday 8.30am - 2.30pm

 

Residential Supported Home Programme

The eight-week Monarch Programme is an educational and life skills based programme that addresses addiction, mental health and social issues.  The residential option is recommended for people who are more vulnerable, from out of town, at risk in their environment, unable to maintain abstinence without 24 hour support, are in abusive relationships, or influenced by peer pressure.  This is a supported living environment through 24/7 support and supervision.  Attendance of the programme Monday – Friday 8.30am - 2.30pm.

Support Groups

Support Group is on a Tuesday 1:30pm - 2:30pm.  It is a safe non-judgemental group where you can just "be".  

What service/s would you like to attend? *

See "Services we Provide" above for a detailed description of each of the listed services
Section 4:  Finishing up!
Upload Supporting Documents

Thanks for submitting! Our team will be in contact with you.

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