Referral Form

1 2 3 4 5 6

Page 1 of 6

Please fill in as many details as you can manage.

Young Person's Details

Name *

Date of Birth

Day

Month

Year

NHI Number

Age

Ethnicity

Gender

GP's Name

Address

Mobile

Phone

School

Year

feed me

To prevent automated spam submissions leave this field empty.

Success stories

Committed to programme

Client has remained in Odyssey House for two months and remains committed to the programme.

Client is looking to remain in Auckland post graduation and attend studies in psychology with a Maori component.

Odyssey House will support clients transition to achieve this.

Mum is proud of clients commitment and efforts.

Ultimatum

After two years of positive test results, client had been unable to sustain abstinence.

School gave an ultimatum to enter residential rehab or an alternative education programme.

Residential rehab info was provided to client and both parents.

Client chose to enter workforce and was required to have two reducing tests in order for the Ministry of Education to approve exemption from school.

First clear test result was achieved and client is motivated to access employment options.

Suicide Risk

Client presented with suicidal ideation and one attempt.

Heavy cannabis and alcohol use.

Fortnightly counselling sessions and a year later, the client completed clear drug tests and is now looking at entering Tertiary Education.

We have also been personally thanked by client, stating client would not be where client is if it had not been for Rubicon's programme and fortnightly counselling sessions.

Client is now drug free and is looking at universities to attend.

Teens Camp

We wish to thank you for giving us the opportunity to take part in the Discovery Teens Camp. We are looking forward to taking part in the changes ahead of us.

We will be sure to show and use the strategies that Rubicon has taught us.

We would also like to thank Rubicon for all that they have done for us and the support over the years.

We appreciate it.