Uenuku Ki Te Rangi

The Comforter of All People


Hospice Waikato
Hospice Waikato’s Rainbow Place is New Zealand’s only specialist children’s and young person’s hospice service.





Make a Donation

If you’re thinking about making a gift or donation of any kind, or if you’re interested in becoming a volunteer with Rainbow Place please get in touch.


How Can We Help?

Rainbow Place has a quick and easy referral process for any healthcare professional, counsellor or any person working with children and young people.

Rainbow Place Referral Criteria

If a young person in your care meets any of the following criteria, please use our online referral form to get in touch.  Alternatively, you can phone, fax or print one off and send via standard mail.

 

  1. Children and young people affected by the serious illness of a loved one
  2. Children and young people who themselves have a serious illness
  3. Children and young people affected by the death of a loved one (including sudden death) - according to available caseload capacity and resources.

     

 

If you’re unsure whether a child or young person fits our criteria, please give us a call and discuss the situation with one of the Rainbow Place team.  We’re very happy to hear about anyone who may benefit from our services.

 

To make a referral please fill out the form below or download and fax the below form.

Rainbow Place Referral Form 328.7KB

Referral Form

Full Name Gender
DOBEthnicity
Relationship to Seriously ill or Deceased Person  
    
Full Name
Gender
DOB
Ethnicity
Relationship to Seriously ill or Deceased Person

  
    
Full Name
Gender
DOB
Ethnicity
Relationship to Seriously ill or Deceased Person
  
    
Address
Phone
Mobile
Email



Post code
  
    
Parent(s) / Caregiver(s)
Child/ren live with
    
Reason for referral / Area of concern
 
    
 
Information regarding seriously ill / deceased person (if different from above)
 
Name
NHI Number
    
(Please tick appropriate boxes)
Seriously ill     Hospice Waikato Patient        
GP      Consultant
    
Deceased:Following serious illness     or sudden death      Date of death
    
    
Referred by
Role/Organisation
  Phone
  Fax
 
Is the family aware of the referral and given consent?
 
    
    
Other professionals / agencies involved
How did you hear about the service?