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Website Referral

To make a referral to our service, please enter the details below.

Click below if this is a Self Referral

This is a Self Referral

Client Details

Name(Required)

First Last

Preferred Name

Sex

Ethnicity

Phone(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth(Required)

Day

Month

Year

Agency Referrer Details

Referrer Name(Required)

Referrer Organisation(Required)

Referrer Phone:(Required)

Referrer Email

Police File Number (if Police referral)

Officer ID (if Police referral)

Have the Police submitted a Victim Support Grant?

Yes

Is there a forensic examination pending? *(1)

Yes

Is there a Police interview pending? *(2)

Yes

Is there a court appearance pending?

Yes

Is there any risk/safety concerns? *(3)

Yes

Unsure

If external referral, has the survivor consented to this referral?

Yes

Referrer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Service Required

Comments

*(1) - If yes, Please specify date and time of intervew. *(2) - If yes, Please state safety/risk concerns *(3) - If yes, Please specify date and time of exam

To access any or our services or to talk in confidence to someone who will understand, please reach out to use below.

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Visit Us

Dunbar House,
21 Dunbar St, Dunedin Central 9016



OCASA Hotline

Call (03) 474 1592

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Email Us

Click here to email us directly

ADDRESS

Level one, Dunbar House
21 Dunbar Street
Dunedin Central, Dunedin 9016
PO Box 5424, Dunedin

Our office is on the first floor, up a flight of stairs. Please contact us if you would like to speak about accessibility to our space.

CONTACT US

Support line: (03) 474-1592.
*Please leave a voicemail if the line is busy.
Email Support Here
Admin line: (03) 470-1109

OPENING HOURS

9am - 5pm Weekdays