Hoki ki te Rito - Ōranga Whānau / Mellow Parenting Programme Referral Form
Facilitated by Ohomairangi Trust, based in different community settings around Tāmaki Makaurau.
Hoki ki te Rito - Ōranga Whānau / Mellow Parenting Programme is focused on building secure relationships between parents and their child(ren) aged 0-5 years.  Mum's and Dad's groups are separate in the morning sessions and parents/caregivers combine in Babies and Toddlers groups in the sessions after lunch - couples and single parents can attend.  
We encourage parents who are working to retain day to day care of their children, or working toward children returning from care, to attend.  
Our facilitators work with the group to explore past, present & future experiences, over 14 weeks, one day a week, 9:30am - 2:30pm.
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Parent Information
The following questions are about the Parent(s) for referral:
Name of Caregiver(s) *
Current Address *
Caregiver's Contact Number *
Emergency Contact *
Caregiver's Email *
Ethnicities *
Relationship to child 
Please specify your relationship to child to indicate which group you will join e.g. Mother, Father, Aunty, Uncle etc.
Child 1 Name *
Child 1 Age *
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Child 2 Name
Child 2 Age
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Child 3 Name
Child 3 Age
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Child 4 Name
Child 4 Age
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Reason for request *
Referrer Information
The following questions are about the Referrer
Referrer's Name *
Referrer's Contact Number *
Referrer's Email
Relationship to whānau *
Thank you for your referral, we will contact the participant as part of our enrolment process. Please see our website for next programme start dates and venues.
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