Refer a patient

Healthcare professional referrals

Aotearoa Diabetes Collective (ADC) provides specialist diabetes care for adults, children and young people, with appointments available in Hamilton, Thames, Tauranga and online throughout New Zealand.

We welcome referrals from GPs and other healthcare professionals for people who would benefit from specialist diabetes assessment, advice or ongoing care. You can view our referral guide here.

Please complete the secure referral form below. Our team will review your referral and contact the patient regarding next steps.

Alternatively, you can also refer through Specialist & Referrals in your practice management system.

Not a healthcare professional but looking to book an appointment for yourself or someone you care for? You don't need a referral to access our private clinic. Please visit our Private Diabetes Clinic page to learn more and complete our self-referral form.

Patient Details

Patient's first and middle names

Patient's last name

Patient's date of birth (DD/MM/YYYY)

Patient's NHI (if known)

How does the patient identify their gender?

How does the patient identify their ethnicity?

Patient's email address

Patient's phone number

Patient's address

Patient's registered general practice

Patient's usual GP or nurse practitioner

Patient's usual pharmacy (name and location)

Patient's hospital diabetes team (if applicable)

Referral details

Service requested

Patient's preferred appointment type

Patient's type of diabetes

Medical History (Including diabetes type & any complications)

Current Medications

Any Allergies or Alerts

Reason for referral and relevant clinical information (please include current management and any specific concerns or support required)

Upload relevant clinical documents such as clinic letters, GP records, lab results or retinal photo screening reports(if available)

Up to 5 image or document files (10MB limit per file)

Referring healthcare professional

Your full name

Your professional role

Practice or organisation

Your email address

Your contact phone number

Consent and privacy

I confirm that the patient (or their parent, guardian or authorised representative, where appropriate) has been informed of this referral and that I am authorised to share the information provided with Aotearoa Diabetes Collective for the purposes of assessing and coordinating their care.

Address

Message Sent.

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Aotearoa Diabetes Collective Limited
170 Collingwood Street
Hamilton 3204
0800 439 232
Email Us
Registered Charity CC59783
NZBN 9429050075935